Provider Demographics
NPI:1457244279
Name:CRUM, DYLAN THOMAS (MSW, LSW)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:THOMAS
Last Name:CRUM
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 W 8TH AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-2353
Mailing Address - Country:US
Mailing Address - Phone:419-344-7781
Mailing Address - Fax:
Practice Address - Street 1:5491 SCIOTO DARBY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1324
Practice Address - Country:US
Practice Address - Phone:419-344-7781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2512327104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker