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NPI Code Detail

MEDICARE: SHAWANNA WILLIS-SHERELS

MEDICARE: SHAWANNA WILLIS-SHERELS
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1265945299
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWANNA WILLIS-SHERELS
Provider Business Mailing Address
First Line : 38882 MENTOR AVE
Second Line :
City : WILLOUGHBY
State : OH
Zip : 44094-7875
Country : US
Telephone Number : 440-953-9999
Fax Number : 440-918-3839
Provider Business Practice Location Address
First Line : 21100 SOUTHGATE PARK BLVD
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-3004
Country : US
Telephone Number : 440-953-9999
Fax Number : 440-918-3839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2017
Last Update Date : 11/13/2017

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Directions to “ SHAWANNA WILLIS-SHERELS ” Practice Location

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