Provider Demographics
NPI:1861408346
Name:CRAWFORD, YAEL T (PHD)
Entity type:Individual
Prefix:
First Name:YAEL
Middle Name:T
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:216-383-6616
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3881
Practice Address - Fax:216-844-5883
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1894103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0408204Medicaid
OH4303772OtherAETNA
OH000000532993OtherANTHEM
OH000000224256OtherUNISON
OH363450OtherWELLCARE MEDICAID
OH680011201OtherRAILROAD MEDICARE
OH000000224256OtherUNISON
OH363450OtherWELLCARE MEDICAID
OHCRCP05564Medicare PIN
OHCRCP05562Medicare PIN