Provider Demographics
NPI:1962767509
Name:MCCROSKEY, ELIZABETH ANN (LISW, MSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:MCCROSKEY
Suffix:
Gender:F
Credentials:LISW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 UNION ST
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3919
Mailing Address - Country:US
Mailing Address - Phone:740-349-7066
Mailing Address - Fax:740-345-6028
Practice Address - Street 1:195 UNION ST
Practice Address - Street 2:SUITE B-1
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3919
Practice Address - Country:US
Practice Address - Phone:740-349-7066
Practice Address - Fax:740-345-6028
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-1200829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI-1200829OtherLICENSE