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NPI Code Detail

MEDICARE: MS. CRISSANDRA EVANS CDCA

MEDICARE: MS. CRISSANDRA EVANS CDCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor050347OH
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1316216294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CRISSANDRA EVANS CDCA
Provider Business Mailing Address
First Line : 2600 VICTORY PKWY
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-1711
Country : US
Telephone Number : 513-751-7747
Fax Number : 513-751-0180
Provider Business Practice Location Address
First Line : 7373 BROOKCREST DR STE 354
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3448
Country : US
Telephone Number : 513-802-5642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2011
Last Update Date : 09/21/2023

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Directions to “ MS. CRISSANDRA EVANS CDCA” Practice Location

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