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NPI Code Detail

MEDICARE: MS. DOROTHY LEE BROWN-LEWIS LSW., LCDC III

MEDICARE: MS. DOROTHY LEE BROWN-LEWIS LSW., LCDC III
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCDC.954267-3OH
2104100000XSocial WorkerS.0022819OH

General Provider Information

NPI Number : 1639589211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DOROTHY LEE BROWN-LEWIS LSW., LCDC III
Provider Business Mailing Address
First Line : 1905 EAST 89TH. STREET
Second Line :
City : CLEVELAND
State : OH
Zip : 44106
Country : US
Telephone Number : 216-231-3772
Fax Number : 216-231-5040
Provider Business Practice Location Address
First Line : 1905 E 89TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2007
Country : US
Telephone Number : 216-231-3772
Fax Number : 216-231-5040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2014
Last Update Date : 05/05/2014

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