MEDICARE: CAROLINE CORBITT 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
1	104100000X	Social Worker	S.2105770	OH

General Provider Information

NPI Number	:	1548994981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE CORBITT LSW

Provider Business Mailing Address
First Line	:	310 W LAKESIDE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1044
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 W LAKESIDE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1044
Country	:	US
Telephone Number	:	216-443-7375
Fax Number	:

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

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/12/2022

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Directions to “ CAROLINE CORBITT LSW” Practice Location

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