Provider Demographics
NPI:1285260729
Name:CRUMP, BEVERLY (PHD)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:
Last Name:CRUMP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3099 SULLIVANT AVE STE H
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1800
Mailing Address - Country:US
Mailing Address - Phone:614-371-2303
Mailing Address - Fax:
Practice Address - Street 1:4889 SINCLAIR RD STE 215
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5434
Practice Address - Country:US
Practice Address - Phone:614-371-2303
Practice Address - Fax:800-905-9950
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral