Healthcare Provider Details
I. General information
NPI: 1932768298
Provider Name (Legal Business Name): NAOMI ZHOU LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/11/2019
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7232 JUSTIN WAY
MENTOR OH
44060-4881
US
IV. Provider business mailing address
7232 JUSTIN WAY
MENTOR OH
44060-4881
US
V. Phone/Fax
- Phone: 440-578-8200
- Fax:
- Phone: 440-578-8200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | S.1700084 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | S.1700084 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: