Provider Demographics
NPI:1679184311
Name:CRITELLI, ASHLEY ONEITA (LISW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ONEITA
Last Name:CRITELLI
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 1:3075 W ELM ST STE A
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2514
Mailing Address - Country:US
Mailing Address - Phone:567-588-0220
Mailing Address - Fax:567-588-0377
Practice Address - Street 1:3075 W ELM ST STE A
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2514
Practice Address - Country:US
Practice Address - Phone:567-588-0220
Practice Address - Fax:567-588-0377
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2001389-TRNE104100000X
OHI.24051301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker