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NPI Code Detail

MEDICARE: CRYSTAL ROSE PICKUS LSW

MEDICARE:   CRYSTAL ROSE PICKUS  LSW
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 WorkerS.1802031OH

General Provider Information

NPI Number : 1932796539
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL ROSE PICKUS LSW
Provider Business Mailing Address
First Line : 4493 SILSBY RD
Second Line :
City : UNIVERSITY HEIGHTS
State : OH
Zip : 44118-3938
Country : US
Telephone Number : 216-849-9196
Fax Number :
Provider Business Practice Location Address
First Line : 4493 SILSBY RD
Second Line :
City : UNIVERSITY HEIGHTS
State : OH
Zip : 44118-3938
Country : US
Telephone Number : 216-849-9196
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2020
Last Update Date : 12/29/2020

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Directions to “ CRYSTAL ROSE PICKUS LSW” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.