Healthcare Provider Details

I. General information

NPI: 1275372526
Provider Name (Legal Business Name): LEXY CROW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEXY EVANTO

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3795 LEONA AVE
SHADYSIDE OH
43947-1367
US

IV. Provider business mailing address

68353 BANNOCK RD
SAINT CLAIRSVILLE OH
43950-9736
US

V. Phone/Fax

Practice location:
  • Phone: 614-360-0103
  • Fax: 740-695-7787
Mailing address:
  • Phone: 740-695-9344
  • Fax: 740-695-7787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberBP00947596
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: