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General NPI Number Information
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NPI Number | 1073709234
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Entity Type | Individual
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Provider Name | LAUREN GIVAN LISW
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Gender | Female
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 16101 SNOW RD
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City | BROOKPARK
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State | OH
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Zip | 44142-2817
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Country | US
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Telephone | 440-260-8327
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Fax | 440-260-8305
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Provider Business Mailing Address
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Address Line | 5515 ROBERT CT
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City | NORTH RIDGEVILLE
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State | OH
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Zip | 44039-1777
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Country | US
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Telephone | 440-508-6105
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Fax | 440-260-8305
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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 | 6801093886
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License Number State | MI
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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.1501255
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License Number State | OH
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