Provider Demographics
NPI:1225817067
Name:SLEDGE, CRYSTAL D
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:D
Last Name:SLEDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E 272ND ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1724
Mailing Address - Country:US
Mailing Address - Phone:216-240-9482
Mailing Address - Fax:
Practice Address - Street 1:4415 EUCLID AVE STE 315
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3758
Practice Address - Country:US
Practice Address - Phone:216-465-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker