Provider Demographics
NPI:1881336584
Name:CREWS, GRANT SHANE (LPC)
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:SHANE
Last Name:CREWS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:SHANE
Other - Middle Name:
Other - Last Name:CREWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:519 NORWICH STREET
Mailing Address - Street 2:APT 205
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3823
Mailing Address - Country:US
Mailing Address - Phone:912-670-0996
Mailing Address - Fax:912-449-7060
Practice Address - Street 1:434 BRYAN ST
Practice Address - Street 2:
Practice Address - City:NAHUNTA
Practice Address - State:GA
Practice Address - Zip Code:31553-4964
Practice Address - Country:US
Practice Address - Phone:912-462-5849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health