Provider Demographics
NPI:1437234762
Name:CRITES, LISA (LISW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CRITES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-1223
Mailing Address - Country:US
Mailing Address - Phone:330-343-8171
Mailing Address - Fax:330-343-8439
Practice Address - Street 1:1433 5TH ST NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-1223
Practice Address - Country:US
Practice Address - Phone:330-343-8171
Practice Address - Fax:330-343-8439
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00149011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical