Healthcare Provider Details

I. General information

NPI: 1619324738
Provider Name (Legal Business Name): CRYSTAL SMITH PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N FORGE ST
AKRON OH
44304-1407
US

IV. Provider business mailing address

3088 WADSWORTH RD STE 7
NORTON OH
44203-5216
US

V. Phone/Fax

Practice location:
  • Phone: 330-379-8190
  • Fax:
Mailing address:
  • Phone: 330-576-5857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0034941
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.372797
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: