Healthcare Provider Details

I. General information

NPI: 1457816415
Provider Name (Legal Business Name): MICHELLE NORWOOD-KNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 W PARK DR
LORAIN OH
44053-1138
US

IV. Provider business mailing address

7921 NEW YORK AVE
CLEVELAND OH
44105-5947
US

V. Phone/Fax

Practice location:
  • Phone: 440-989-4900
  • Fax: 440-282-4779
Mailing address:
  • Phone: 216-512-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number169478
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number001013
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: