MEDICARE: LEIGH R CASCIOLI MSW/LISW

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	I-4387	OH

General Provider Information

NPI Number	:	1912953720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH R CASCIOLI MSW/LISW

Provider Business Mailing Address
First Line	:	8402 BLACKJACK ROAD EXT
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-9193
Country	:	US
Telephone Number	:	740-397-0442
Fax Number	:	740-392-1814

Provider Business Practice Location Address
First Line	:	8402 BLACKJACK ROAD EXT
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-9193
Country	:	US
Telephone Number	:	740-397-0442
Fax Number	:	740-392-1814

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/08/2007

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