Provider Demographics
NPI:1225709041
Name:CRABTREE, AMANDA B (LSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:CRABTREE
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 1:1301 SHERIDAN CT
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1618
Mailing Address - Country:US
Mailing Address - Phone:937-408-2189
Mailing Address - Fax:
Practice Address - Street 1:305 PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-3893
Practice Address - Country:US
Practice Address - Phone:937-408-2189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2207640104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker