NPIMap

Organization Active NPI

Crucible Life Resources

  • Professional Counselor
  • Toledo, OH
National Provider Identifier
1427494772
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C1100264 Issued in OH
Legal business name
CRUCIBLE LIFE RESOURCES
Practice address
3130 Executive Pkwy
Suite 908
Toledo, OH 43606-5529
Phone
(419) 344-3671
NPI assigned
May 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William K Roman, LMSWNPI 1043563067
Title
LMSW
Phone
(419) 344-3671

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X C1100264 OH Primary

Addresses

Primary practice location

3130 Executive Pkwy
Suite 908
Toledo, OH 43606-5529

Mailing address

3408 Christie Blvd
Toledo, OH 43606-2863
Phone (419) 344-3671

National Provider Directory

National Provider Directory

Locations

3130 Executive Pkwy
Ste 908
Toledo, OH 43606
Phone (419) 344-3671

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1427494772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3408 CHRISTIE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436062863",
            "telephone_number": "419-344-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 EXECUTIVE PKWY",
            "address_2": "SUITE 908",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065529",
            "telephone_number": "419-344-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUCIBLE LIFE RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LMSW",
        "authorized_official_telephone_number": "419-344-3671",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C1100264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.