Provider Demographics
NPI:1558583500
Name:CRISP, JANET (LCSW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CRISP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13932 FOLKESTONE CIRCLE
Mailing Address - Street 2:UNIT A
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:954-802-4946
Mailing Address - Fax:
Practice Address - Street 1:13932 FOLKESTONE CIRCLE
Practice Address - Street 2:UNIT A
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:954-802-4946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2025-09-15
Deactivation Date:2025-06-12
Deactivation Code:
Reactivation Date:2025-07-28
Provider Licenses
StateLicense IDTaxonomies
FLSW236381041C0700X, 106H00000X, 101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty