Individual
TODD PRENTICE CRANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LCDCIII
Contact information
Practice address
5800 MONROE ST., BUILDING D SUITE 4, SYLVANIA, OH 43560-0160
(419) 344-5383
Mailing address
PO BOX 160, SYLVANIA, OH 43560-0160
(419) 344-5383
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E0602167
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
081152
OH
101YM0800X
Mental Health Counselor
E0602167
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081152
LCDCIII
OH
01
—
E0602167
LPCC
OH
Enumeration date
08/05/2016
Last updated
08/05/2016
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