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General NPI Number Information
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NPI Number | 1053804039
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Entity Type | Individual
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Provider Name | MICHELE A ELBA SWA/CARE COORDINATOR
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Gender | Female
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 2800 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-2408
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Country | US
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Telephone | 216-798-4250
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 EUCLID AVE STE 33
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City | CLEVELAND
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State | OH
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Zip | 44115-2408
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Country | US
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Telephone | 234-334-2393
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Fax |
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.173588
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2001623-TRNE
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | W.2100299
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License Number State | OH
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