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NPI Code Detail

MEDICARE: MICHELE RENE CAMPBELL LSW

MEDICARE: MICHELE RENE CAMPBELL LSW
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
1104100000XSocial WorkerS0001544OH

General Provider Information

NPI Number : 1194994541
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE RENE CAMPBELL LSW
Provider Business Mailing Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number : 216-623-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2008
Last Update Date : 02/17/2020

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Directions to “ MICHELE RENE CAMPBELL LSW” Practice Location

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