Provider Demographics
NPI:1356720346
Name:CRISLER, JOSSELINE M (QMHP, LSW)
Entity type:Individual
Prefix:
First Name:JOSSELINE
Middle Name:M
Last Name:CRISLER
Suffix:
Gender:F
Credentials:QMHP, LSW
Other - Prefix:
Other - First Name:JOSSELINE
Other - Middle Name:M
Other - Last Name:GONZALEZ SIERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SWA
Mailing Address - Street 1:108 ERIN CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-8591
Mailing Address - Country:US
Mailing Address - Phone:740-775-1260
Mailing Address - Fax:
Practice Address - Street 1:108 ERIN CT
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8591
Practice Address - Country:US
Practice Address - Phone:937-393-9946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
OHS.2309994104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0287859Medicaid