=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093220444
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIANE J LEVERT LSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2017
-----------------------------------------------------
Last Update Date | 10/28/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23412 COMMERCE PARK
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-5813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-400-6640
-----------------------------------------------------
Fax | 216-250-7016
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 349 SKYVIEW RD
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44109-3749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-970-4207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | S.1700985
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------