Healthcare Provider Details

I. General information

NPI: 1710898499
Provider Name (Legal Business Name): KELLY STOPPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26777 LORAIN RD STE 317
NORTH OLMSTED OH
44070-3225
US

IV. Provider business mailing address

5913 AVON BELDEN RD
NORTH RIDGEVILLE OH
44039-1360
US

V. Phone/Fax

Practice location:
  • Phone: 216-389-4098
  • Fax:
Mailing address:
  • Phone: 419-315-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2605270-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: