Healthcare Provider Details

I. General information

NPI: 1962248443
Provider Name (Legal Business Name): SHOSHANAH CHAYA LEBOVITS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHOSHANAH CHAYA POST LSW

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0002
US

IV. Provider business mailing address

4298 SILSBY RD
UNIVERSITY HEIGHTS OH
44118-3962
US

V. Phone/Fax

Practice location:
  • Phone: 216-363-2122
  • Fax:
Mailing address:
  • Phone: 216-978-5069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2410598
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: