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NPI Code Detail

MEDICARE: ALPHA SUDANO LISW-S

MEDICARE: ALPHA SUDANO 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
11041C0700XClinical Social WorkerI.0900319-SUPVOH

General Provider Information

NPI Number : 1982547675
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALPHA SUDANO LISW-S
Provider Business Mailing Address
First Line : 23195 WAINWRIGHT TER
Second Line :
City : OLMSTED FALLS
State : OH
Zip : 44138-3213
Country : US
Telephone Number : 216-409-4074
Fax Number :
Provider Business Practice Location Address
First Line : 925 KEYNOTE CIR STE 300
Second Line :
City : BROOKLYN HTS
State : OH
Zip : 44131-1869
Country : US
Telephone Number : 216-631-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ ALPHA SUDANO LISW-S” Practice Location

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