Provider Demographics
NPI:1750648168
Name:CRASE-HICKS, CYNTHIA (LCSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CRASE-HICKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:CRASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-0102
Mailing Address - Country:US
Mailing Address - Phone:606-506-4340
Mailing Address - Fax:606-506-4339
Practice Address - Street 1:1184 S LAKE DR STE 2
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1349
Practice Address - Country:US
Practice Address - Phone:606-506-4340
Practice Address - Fax:606-506-4339
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100821660Medicaid
KY5132OtherLCSW