Provider Demographics
NPI:1447505383
Name:CRUMP, DANIEL PHILLIP JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:PHILLIP
Last Name:CRUMP
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 EDISON WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4100
Mailing Address - Country:US
Mailing Address - Phone:775-858-4553
Mailing Address - Fax:
Practice Address - Street 1:690 EDISON WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4100
Practice Address - Country:US
Practice Address - Phone:775-858-4553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6296-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical