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NPI Code Detail

MEDICARE: KEITH FRANKLIN LISW

MEDICARE: KEITH FRANKLIN 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
1101Y00000XCounselorS1800499-TRNE
21041C0700XClinical Social WorkerI.2507606OH
3104100000XSocial WorkerS.1800499-TRNEOH

General Provider Information

NPI Number : 1215421060
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH FRANKLIN LISW
Provider Business Mailing Address
First Line : 434 EASTLAND RD
Second Line :
City : BEREA
State : OH
Zip : 44017-1217
Country : US
Telephone Number : 440-234-2006
Fax Number :
Provider Business Practice Location Address
First Line : 3500 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2641
Country : US
Telephone Number : 440-260-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2018
Last Update Date : 03/19/2026

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Directions to “ KEITH FRANKLIN LISW” Practice Location

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