Healthcare Provider Details

I. General information

NPI: 1912723511
Provider Name (Legal Business Name): MS. STEPHANIE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20700 SOUTHGATE PARK BLVD
MAPLE HEIGHTS OH
44137-2913
US

IV. Provider business mailing address

20700 SOUTHGATE PARK BLVD
MAPLE HEIGHTS OH
44137-2913
US

V. Phone/Fax

Practice location:
  • Phone: 216-510-5101
  • Fax:
Mailing address:
  • Phone: 216-510-5101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2511914
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: