| Crestview Mental Health Of Ohio, Llc | |
|
5134 Cedar Village Dr Mason OH 45040-3717 | |
| (513) 229-7900 | |
| Not Available |
| Full Name | Crestview Mental Health Of Ohio, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5134 Cedar Village Dr, Mason, Ohio |
| Authorized Official Name and Position | Brandon Golder (PARTNER/CEO) |
| Authorized Official Contact | 7197177113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestview Mental Health Of Ohio, Llc 5134 Cedar Village Dr Mason OH 45040-3717 Ph: () - | Crestview Mental Health Of Ohio, Llc 5134 Cedar Village Dr Mason OH 45040-3717 Ph: (513) 229-7900 |
| NPI Number | 1235850405 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/02/2022 |
| Medicare PECOS PAC ID | 7315392438 |
|---|---|
| Medicare Enrollment ID | O20231010002184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235850405 | NPI | - | NPPES |
| Provider Name | Sara R Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548798374 PECOS PAC ID: 7214319888 Enrollment ID: I20220728001693 |
| Provider Name | Elanna Hope Wilson-guzman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932403045 PECOS PAC ID: 8426413576 Enrollment ID: I20230425002493 |
| Provider Name | Danielle Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194408286 PECOS PAC ID: 6204282692 Enrollment ID: I20231020001445 |
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