Provider Demographics
NPI:1912492224
Name:CRUTCHFIELD, YOLANDA DENISE (LSW)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:DENISE
Last Name:CRUTCHFIELD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 MIDPINES DR APT 148
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1650
Mailing Address - Country:US
Mailing Address - Phone:513-370-9963
Mailing Address - Fax:
Practice Address - Street 1:1110 PENDLETON ST STE 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-8819
Practice Address - Country:US
Practice Address - Phone:513-421-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0900675104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker