Healthcare Provider Details

I. General information

NPI: 1922105576
Provider Name (Legal Business Name): ROSS S PLANOVSKY LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11565 PEARL RD STE 300
STRONGSVILLE OH
44136-3356
US

IV. Provider business mailing address

23935 BEAUMONT DR
NORTH OLMSTED OH
44070-1579
US

V. Phone/Fax

Practice location:
  • Phone: 440-846-0862
  • Fax:
Mailing address:
  • Phone: 440-801-1085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0700140
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: