Healthcare Provider Details

I. General information

NPI: 1639687254
Provider Name (Legal Business Name): DIANA LYNN WARMAN MSSA, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1744 PAYNE AVE
CLEVELAND OH
44114-2910
US

IV. Provider business mailing address

27281 FORESTVIEW AVE
EUCLID OH
44132-1726
US

V. Phone/Fax

Practice location:
  • Phone: 216-623-6555
  • Fax: 216-623-6539
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1901416
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1601196
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: