Provider Demographics
NPI:1063907863
Name:FURMAN, CRYSTAL (LCDCII, SW-A, PRS)
Entity type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:
Last Name:FURMAN
Suffix:
Gender:F
Credentials:LCDCII, SW-A, PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 S HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3902
Mailing Address - Country:US
Mailing Address - Phone:330-867-5400
Mailing Address - Fax:330-869-8263
Practice Address - Street 1:1735 S HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320
Practice Address - Country:US
Practice Address - Phone:330-867-5400
Practice Address - Fax:330-869-8263
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.000469175T00000X
OHLCDCII.161637101YA0400X
171M00000X
OHW.1900198104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker