Individual
CRYSTAL WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSA, LISW-S
Contact information
Practice address
3518 W 25TH ST, CLEVELAND, OH 44109-1951
(216) 741-2241
(216) 741-2632
Mailing address
3518 W 25TH ST, CLEVELAND, OH 44109-1951
(216) 741-2241
(216) 741-2632
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-9676 (SUPV)
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000291469
ANTHEM PIN NUMBER
OH
01
—
579472000
MAGELLAN MIS NUMBER
OH
Enumeration date
06/14/2006
Last updated
02/04/2016
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