Healthcare Provider Details

I. General information

NPI: 1316435951
Provider Name (Legal Business Name): MEREDITH CARNOVALE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 N RIDGE RD E STE C
LORAIN OH
44055-3360
US

IV. Provider business mailing address

1865 N RIDGE RD E STE C
LORAIN OH
44055-3360
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-5701
  • Fax:
Mailing address:
  • Phone: 440-324-5701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: