Healthcare Provider Details

I. General information

NPI: 1376311860
Provider Name (Legal Business Name): KARLA SEESE LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21270 LORAIN RD
FAIRVIEW PARK OH
44126-2121
US

IV. Provider business mailing address

3854 W 146TH ST
CLEVELAND OH
44111-4318
US

V. Phone/Fax

Practice location:
  • Phone: 440-672-1299
  • Fax:
Mailing address:
  • Phone: 216-882-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI2608803
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: