MEDICARE: MELISSA PAPPERT 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
1	1041C0700X	Clinical Social Worker	I.2002063	OH

General Provider Information

NPI Number	:	1184350738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA PAPPERT LISW-S

Provider Business Mailing Address
First Line	:	10011 W PLEASANT VALLEY RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44130-6012
Country	:	US
Telephone Number	:	315-281-3782
Fax Number	:

Provider Business Practice Location Address
First Line	:	12608 STATE RD STE 1
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-3281
Country	:	US
Telephone Number	:	440-907-1141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2022
Last Update Date	:	11/05/2024

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