Provider Demographics
NPI:1053837773
Name:CRUM, DANIEL SCOTT (LSW, LCDC-3)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:SCOTT
Last Name:CRUM
Suffix:
Gender:M
Credentials:LSW, LCDC-3
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 ROSELAND RD
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-3870
Mailing Address - Country:US
Mailing Address - Phone:330-402-3151
Mailing Address - Fax:
Practice Address - Street 1:65 E GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1137
Practice Address - Country:US
Practice Address - Phone:330-996-2222
Practice Address - Fax:330-258-0199
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII.162203101YA0400X
OHS1451308104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)