Provider Demographics
NPI:1144491184
Name:MCCRIMMON, FRANTISHKA (THERAPIST)
Entity type:Individual
Prefix:MISS
First Name:FRANTISHKA
Middle Name:
Last Name:MCCRIMMON
Suffix:
Gender:F
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 GRANT STREET
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376
Mailing Address - Country:US
Mailing Address - Phone:910-673-3535
Mailing Address - Fax:910-673-6565
Practice Address - Street 1:241 GRANT ST
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-8377
Practice Address - Country:US
Practice Address - Phone:910-673-3535
Practice Address - Fax:910-673-6565
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC006546OtherLICENSED CLINICAL SOCIAL WORKER
NCP004028OtherPROVISIONAL NUMBER