Provider Demographics
NPI:1518651215
Name:SWIFT, CRYSTAL (QBHS)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:QBHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3236
Mailing Address - Country:US
Mailing Address - Phone:513-402-2241
Mailing Address - Fax:
Practice Address - Street 1:1000 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-3236
Practice Address - Country:US
Practice Address - Phone:513-402-2241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.2400411-TRNE106H00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator