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NPI Code Detail

MEDICARE: OLIVIA M MYLES LSW

MEDICARE: OLIVIA M MYLES 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
1104100000XSocial WorkerI.2507107OH

General Provider Information

NPI Number : 1770130528
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA M MYLES LSW
Provider Business Mailing Address
First Line : 7232 JUSTIN WAY
Second Line :
City : MENTOR
State : OH
Zip : 44060-4881
Country : US
Telephone Number : 440-578-8200
Fax Number :
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 : 440-578-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2019
Last Update Date : 12/17/2025

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Directions to “ OLIVIA M MYLES LSW” Practice Location

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