MEDICARE: MICHELLE ESPER BRANSKY LISW-S

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	1041C0700X	Clinical Social Worker	7496	OH

General Provider Information

NPI Number	:	1598089401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ESPER BRANSKY LISW-S

Provider Business Mailing Address
First Line	:	6009 LANDERHAVEN DR STE F
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4192
Country	:	US
Telephone Number	:	216-912-0152
Fax Number	:	216-912-0152

Provider Business Practice Location Address
First Line	:	6009 LANDERHAVEN DR STE F
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4192
Country	:	US
Telephone Number	:	216-912-0152
Fax Number	:	216-912-0152

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

Provider Enumeration Date	:	03/22/2010
Last Update Date	:	10/17/2016

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