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NPI Code Detail

MEDICARE: MS. SHARON J. TIPTON LISW-S

MEDICARE: MS. SHARON J. TIPTON LISW-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.0009205-SUPVOH

General Provider Information

NPI Number : 1154672954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHARON J. TIPTON LISW-S
Provider Business Mailing Address
First Line : 2785 SOM CENTER RD
Second Line :
City : WILLOUGHBY HILLS
State : OH
Zip : 44094-6501
Country : US
Telephone Number : 440-943-2500
Fax Number :
Provider Business Practice Location Address
First Line : 2785 SOM CENTER RD
Second Line :
City : WILLOUGHBY HILLS
State : OH
Zip : 44094-6501
Country : US
Telephone Number : 440-975-5575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2012
Last Update Date : 09/20/2012

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