Healthcare Provider Details

I. General information

NPI: 1033399340
Provider Name (Legal Business Name): AMY SCHOLD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24075 COMMERCE PARK
BEACHWOOD OH
44122-5846
US

IV. Provider business mailing address

24075 COMMERCE PARK
BEACHWOOD OH
44122-5846
US

V. Phone/Fax

Practice location:
  • Phone: 216-292-3999
  • Fax: 216-378-2785
Mailing address:
  • Phone: 216-292-3999
  • Fax: 216-378-2785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0800093-S
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: