=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477474542
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAVEN CRUZ LOAIZA MSW,LISW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2026
-----------------------------------------------------
Last Update Date | 07/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8080 BECKETT CENTER DR STE 125
-----------------------------------------------------
City | WEST CHESTER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45069-5039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-520-2632
-----------------------------------------------------
Fax | 937-913-4625
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3784 BEULAH DR
-----------------------------------------------------
City | SIDNEY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45365-9559
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | I.2608469
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------