Provider Demographics
NPI:1962948984
Name:CROSHAL, MARIYA CHARNAYA (LCSW)
Entity type:Individual
Prefix:
First Name:MARIYA
Middle Name:CHARNAYA
Last Name:CROSHAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 OAK GROVE RD
Mailing Address - Street 2:STE E2 PMB4043
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518
Mailing Address - Country:US
Mailing Address - Phone:925-233-6391
Mailing Address - Fax:925-233-6391
Practice Address - Street 1:785 OAK GROVE RD
Practice Address - Street 2:STE E2 PMB4043
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518
Practice Address - Country:US
Practice Address - Phone:925-233-6391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA896451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical