Healthcare Provider Details

I. General information

NPI: 1063907863
Provider Name (Legal Business Name): CRYSTAL FURMAN LSW, LCDCII, AND PRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 S HAWKINS AVE
AKRON OH
44320
US

IV. Provider business mailing address

1735 S HAWKINS AVE
AKRON OH
44320-3902
US

V. Phone/Fax

Practice location:
  • Phone: 330-867-5400
  • Fax: 330-869-8263
Mailing address:
  • Phone: 330-867-5400
  • Fax: 330-869-8263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCII.161637
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS.2512246
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberW.1900198
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.000469
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: