Healthcare Provider Details

I. General information

NPI: 1154969301
Provider Name (Legal Business Name): YVONNE KEY LICDC/LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 10/27/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 CARNEGIE AVE
CLEVELAND OH
44115-2641
US

IV. Provider business mailing address

PO BOX 608223
CLEVELAND OH
44108-0223
US

V. Phone/Fax

Practice location:
  • Phone: 440-260-8300
  • Fax:
Mailing address:
  • Phone: 216-235-4988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number101YA0400X
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS-0019223
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: