=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174894778
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GABRIELA SEHINKMAN MA, LISW-S
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2012
-----------------------------------------------------
Last Update Date | 08/08/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2101 RICHMOND RD STE 1005
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-1390
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-410-2832
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3628 PALMERSTON RD
-----------------------------------------------------
City | SHAKER HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-5014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-410-2832
-----------------------------------------------------
Fax | 216-651-4145
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | I.1000134.SUPV
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------