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General NPI Number Information
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NPI Number | 1043635493
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Entity Type | Individual
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Provider Name | DENISE CASINO LISW
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Gender | Female
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Dates
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Enumeration Date | 02/21/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1744 PAYNE AVE
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City | CLEVELAND
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State | OH
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Zip | 44114-2910
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Country | US
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Telephone | 216-302-5017
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Fax |
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Provider Business Mailing Address
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Address Line | 6151 WILSON MILLS RD SUITE 120
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City | HIGHLAND HEIGHTS
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State | OH
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Zip | 44143-2153
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Country | US
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Telephone | 440-683-1566
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Fax | 440-683-1598
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.0800334
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1700428
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License Number State | OH
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