Healthcare Provider Details

I. General information

NPI: 1558224352
Provider Name (Legal Business Name): STEPHANIE FARKAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23366 COMMERCE PARK STE 100B
BEACHWOOD OH
44122-5801
US

IV. Provider business mailing address

23366 COMMERCE PARK STE 100B
BEACHWOOD OH
44122-5801
US

V. Phone/Fax

Practice location:
  • Phone: 216-292-2880
  • Fax:
Mailing address:
  • Phone: 216-292-2880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1450338
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: