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General NPI Number Information
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NPI Number | 1417744459
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Entity Type | Individual
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Provider Name | CRYSTAL SMITH CDCA, RSWA
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Gender | Female
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 1791 ALUM CREEK DR
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City | COLUMBUS
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State | OH
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Zip | 43207-1757
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Country | US
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Telephone | 614-445-8131
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Fax |
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Provider Business Mailing Address
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Address Line | 4734 MICHAEL PL
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City | GROVE CITY
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State | OH
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Zip | 43123-9460
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Country | US
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Telephone | 614-302-8991
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | W.2400443
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.181865
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License Number State | OH
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