Healthcare Provider Details

I. General information

NPI: 1174176994
Provider Name (Legal Business Name): CYNTHIA ANN JOHNSON MSSA, LSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA A MIERZEJEWSKI

II. Dates (important events)

Enumeration Date: 07/21/2019
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22001 FAIRMOUNT BLVD
CLEVELAND OH
44118-4897
US

IV. Provider business mailing address

5699 ALLENDALE DR
NORTH OLMSTED OH
44070-4655
US

V. Phone/Fax

Practice location:
  • Phone: 216-932-2800
  • Fax:
Mailing address:
  • Phone: 216-952-5682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1000067
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberOH3317861
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2506989
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: