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General NPI Number Information
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NPI Number | 1063121853
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Entity Type | Individual
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Provider Name | SAMANTHA LEE GREY LSW
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Gender | Female
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 22001 FAIRMOUNT BLVD
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City | CLEVELAND
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State | OH
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Zip | 44118-4897
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Country | US
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Telephone | 216-932-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 2064 WYANDOTTE AVE
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City | LAKEWOOD
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State | OH
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Zip | 44107-6136
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Country | US
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Telephone | 440-344-8506
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | S.2208438
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License Number State | OH
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