Healthcare Provider Details

I. General information

NPI: 1568528131
Provider Name (Legal Business Name): LEFTON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36400 MAPLEGROVE RD
WILLOUGHBY OH
44094-6919
US

IV. Provider business mailing address

PO BOX 190
NEWBURY OH
44065-0190
US

V. Phone/Fax

Practice location:
  • Phone: 440-942-4440
  • Fax: 440-942-4727
Mailing address:
  • Phone: 440-942-4440
  • Fax: 440-942-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI4789
License Number StateOH

VIII. Authorized Official

Name: MS. MARLENE RUTH LEFTON
Title or Position: OWNER
Credential: MSSA, LISW
Phone: 440-942-4440