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NPI Code Detail

MEDICARE: KATHLEEN H. DAVIS LISW

MEDICARE: KATHLEEN H. DAVIS LISW
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.1601263OH

General Provider Information

NPI Number : 1205514882
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN H. DAVIS LISW
Provider Business Mailing Address
First Line : 9826 WASHINGTON ST
Second Line :
City : CHAGRIN FALLS
State : OH
Zip : 44023-5401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9826 WASHINGTON ST
Second Line :
City : CHAGRIN FALLS
State : OH
Zip : 44023-5401
Country : US
Telephone Number : 440-708-0188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2023
Last Update Date : 07/05/2023

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Directions to “ KATHLEEN H. DAVIS LISW” Practice Location

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