MEDICARE: SHOLOM STERN

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	101YP2500X	Professional Counselor	C0800344	OH

General Provider Information

NPI Number	:	1255622098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHOLOM STERN

Provider Business Mailing Address
First Line	:	2548 MILTON RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-4649
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2548 MILTON RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-4649
Country	:	US
Telephone Number	:	216-220-5536
Fax Number	:

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

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	04/27/2011

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Directions to “ SHOLOM STERN ” Practice Location

Language	Start Address	Practice Location

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