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NPI Code Detail

MEDICARE: CRYSTAL ALLEN MSW, LISW

MEDICARE: CRYSTAL ALLEN MSW, LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.2507490OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215646138
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL ALLEN MSW, LISW
Provider Business Mailing Address
First Line : PO BOX 837
Second Line :
City : HAMILTON
State : OH
Zip : 45012-0837
Country : US
Telephone Number : 513-454-1111
Fax Number :
Provider Business Practice Location Address
First Line : 1036 S VERITY PKWY
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-5513
Country : US
Telephone Number : 513-454-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2022
Last Update Date : 06/05/2026

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