Provider Demographics
NPI:1235226127
Name:CROSBY, RAY MCPHAIL (PHD)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:MCPHAIL
Last Name:CROSBY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SUMMIT ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237
Mailing Address - Country:US
Mailing Address - Phone:513-948-3600
Mailing Address - Fax:513-948-8631
Practice Address - Street 1:1101 SUMMIT ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237
Practice Address - Country:US
Practice Address - Phone:513-948-3600
Practice Address - Fax:513-948-8631
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4659103TC0700X, 283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150189Medicaid
OHCRCP25972Medicare PIN
OHCRCP-25973Medicare UPIN
OHCRCP25974Medicare PIN
OH3604023Medicare ID - Type Unspecified