Healthcare Provider Details

I. General information

NPI: 1720150345
Provider Name (Legal Business Name): LINDA MUHAMMAD-SMITH L.S.W., L.C.D.C.III
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6591 BASSWOOD DR
CLEVELAND OH
44146-4808
US

IV. Provider business mailing address

6591 BASSWOOD DR
CLEVELAND OH
44146-4808
US

V. Phone/Fax

Practice location:
  • Phone: 440-439-9168
  • Fax: 440-439-9177
Mailing address:
  • Phone: 440-439-9168
  • Fax: 440-439-9177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number041003
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: