Individual provider Active NPI

Ildiko E. Crawford, LISW, ICDC

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1750419503
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0004706 Issued in OH
Practice address
4334 Secor Rd
Toledo, OH 43623-4234
Phone
(419) 475-4449
Fax
(419) 479-3230
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 923316 OH
Clinical Social Worker 1041C0700X I0004706 OH Primary

Addresses

Primary practice location

4334 Secor Rd
Toledo, OH 43623-4234

Mailing address

4334 Secor Rd
Toledo, OH 43623-4234
Phone (419) 475-4449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120416000367 OH Practitioner - Clinical Social Worker 2163683350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sophia Counseling Center IncGroup PAC ID 4385628346, 6 clinicians

Practice addresses (Care Compare)

5335 Silica Dr
Sylvania, OH 43560-1980
Phone (419) 824-3662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
923316OHMDAddiction (Substance Use Disorder) Counselor
I0004706OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sophia Counseling Center Inc CurrentSince Mar 1, 2012 Accepting new patients

Locations

5335 Silica Dr
Sylvania, OH 43560
Phone (419) 824-3662

6832 Convent Blvd
Sylvania, OH 43560
Phone (419) 824-3600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1750419503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234234",
            "telephone_number": "419-475-4449",
            "fax_number": "419-479-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234234",
            "telephone_number": "419-475-4449",
            "fax_number": "419-479-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "ILDIKO",
        "middle_name": "E.",
        "credential": "LISW, ICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "923316",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0004706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.