Healthcare Provider Details

I. General information

NPI: 1295407831
Provider Name (Legal Business Name): BAYLEE EVERETT LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BAYLEE EVANS LISW

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 LORAIN AVE STE 300
CLEVELAND OH
44113-3726
US

IV. Provider business mailing address

3500 LORAIN AVE STE 300
CLEVELAND OH
44113-3726
US

V. Phone/Fax

Practice location:
  • Phone: 216-315-2609
  • Fax:
Mailing address:
  • Phone: 440-952-2149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2506449
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: