Healthcare Provider Details

I. General information

NPI: 1952455149
Provider Name (Legal Business Name): CARLIE CHAPMAN ALI-HASSAN M.S.S.A., L.I.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. CARLIE ANNE CHAPMAN

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4255 NORTHFIELD RD
HIGHLAND HILLS OH
44128-2811
US

IV. Provider business mailing address

3315 AVALON RD
SHAKER HEIGHTS OH
44120-3407
US

V. Phone/Fax

Practice location:
  • Phone: 216-292-9700
  • Fax: 216-292-9721
Mailing address:
  • Phone: 216-410-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI 0031476
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: