KELLY L CRENSHAW (NPI# 1649694662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649694662 |
| Entity Type | Individual |
| Full Name | KELLY L CRENSHAW |
| Credential | PSYD |
| Practice Address |
12 Bellwether Way Ste 240 Bellingham WA 98225-2959 |
| Practice Telephone | 3605882500 |
| Practice Fax Number | 3607852016 |
| Mailing Telephone | 3605882500 |
| Mailing Fax Number | 3607852016 |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2020-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY60885078 | WA | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
PY60885078 | WA | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
36685 | TX | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PY60885078 | WA | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
36685 | TX | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY60885078 | WA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
36685 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790161263 | Kelly Crenshaw | Nurse Practitioner | 1055 Dresser Ct, Raleigh, NC 27609-7323 | 2015-08-06 |
| 1639128218 | Kelly M Crenshaw | Nurse Practitioner | 5455 Meridian Marks Rd Ne, Suite 130, Atlanta, GA 30342-1654 | 2006-05-09 |
| Street Address |
12 BELLWETHER WAY STE 240 |
| City | BELLINGHAM |
| State | WA |
| Zip Code | 98225-2959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871099937 | Cascade Neuropsychology, Pllc | Psychologist | 12 Bellwether Way Ste 240, Bellingham, WA 98225-2959 | 2018-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578183729 | Family Care Network Pllc | Clinic/Center | 3548 Meridian St, Suite #101-b, Bellingham, WA 98225 | 2020-04-17 |
| 1770129264 | Ariella K Ross | Massage Therapist | 2701 Northwest Avenue, Bellingham, WA 98225 | 2019-11-20 |
| 1467006205 | Family Care Network, Pllc | Family Medicine | 805 W. Orchard Drive, Suite 6, Bellingham, WA 98225 | 2019-07-30 |
| 1487110375 | Rhonda Beth Steel | Massage Therapist | Fairhaven Harbor, 1310 9th Street Penthouse No. 504, Fairhaven/bellingham, WA 98225 | 2019-02-15 |
| 1366915316 | Alexander Knight Acupuncture Inc | Acupuncturist | 12 Bellwether Way, Suite 201, Bellingham, WA 98225 | 2019-01-02 |
| 1902372998 | Northwest Telepsychiatry, Pllc | Psychiatry & Neurology | 114 W. Magnolia St., Suite 505, Bellingham, WA 98225 | 2018-10-17 |
| 1639650336 | Jennifer Sue Cogen | Massage Therapist | 2701 Northwest Ave. (ohana Pacific, Inc.), Bellingham, WA 98225 | 2018-08-22 |
| 1013414036 | Tamara C Dee | Social Worker | 1313 E Maple St Ste 229, Bellingham, WA 98225 | 2018-04-06 |
| 1417468596 | Samantha Grace Smith | Counselor | 920 Harris Avenue, 202-e, Bellingham, WA 98225 | 2017-10-17 |
| 1710406731 | Shalom Maria Shreve | Counselor | 1133 Railroad Ave., Suite 100, Bellingham, WA 98225 | 2017-09-11 |
| Find all providers in zip 98225 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811179526 | John E. Neer | Clinical Neuropsychologist | 1200 Harris Avenue, Suite 306, Bellingham, WA 98225-7145 | 2007-12-04 |
| 1447223763 | Jody Ann Veltkamp | Clinical Neuropsychologist | 192 E Bakerview Road, Suite 102, Bellingham, WA 98226 | 2006-02-08 |
| 1053457333 | Elizabeth Nyblade | Clinical Neuropsychologist | 1116 Key St, Suite 213, Bellingham, WA 98225-5232 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757010 | Corianne Raychael Lawrence | Clinical Neuropsychologist | 112 N 14th St, Selah, WA 98942-1713 | 2019-02-25 |
| 1588138333 | Mynd Group LLC | Clinical Neuropsychologist | 1066 View Ridge Dr, Oak Harbor, WA 98277-8265 | 2019-01-15 |
| 1588163208 | Johanah Y Kang | Clinical Neuropsychologist | 2013 South 19th Street, Tacoma, WA 98405 | 2018-02-08 |
| 1669850681 | Neuropsychological Services of The South Sound LLC | Clinical Neuropsychologist | 2620 R W Johnson Rd Sw Ste 204, Tumwater, WA 98512-6133 | 2015-05-11 |
| 1710372412 | Daniela Ferdico | Clinical Neuropsychologist | 2101 112th Ave Ne, Suite 100, Bellevue, WA 98004-2944 | 2015-03-31 |
| 1689069502 | Erica K Johnson | Clinical Neuropsychologist | 19000 33rd Ave W Ste 100, Lynnwood, WA 98036-4750 | 2015-03-30 |
| 1659776474 | Rodger Meinz | Clinical Neuropsychologist | 12712 Admiralty Way, B-101, Everett, WA 98204-5562 | 2014-10-23 |
| 1952704413 | Brad Tyson | Clinical Neuropsychologist | 12039 Ne 128th St Fl 3, Kirkland, WA 98034-3029 | 2014-09-29 |
| 1508289299 | Neuropsychology and Cognitive Health | Clinical Neuropsychologist | 1808 Richards Rd #120, Bellevue, WA 98005-3982 | 2014-01-30 |
| 1104105816 | Leapss and Beyond | Clinical Neuropsychologist | 413 Lincoln Ave Ste A, Mukilteo, WA 98275-1524 | 2011-08-11 |
| Find all providers with the same taxonomy | ||||
| City | BELLINGHAM |
| Zip Code | 98225 |
Please comment or provide details below to improve the information on KELLY L CRENSHAW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.