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General NPI Number Information
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NPI Number | 1184112997
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Entity Type | Individual
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Provider Name | ANTON CROSS MSW, LSW LSW,MSW
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Gender | Male
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 2301 SCRANTON RD
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City | CLEVELAND
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State | OH
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Zip | 44113-4311
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Country | US
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Telephone | 216-273-6998
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Fax |
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Provider Business Mailing Address
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Address Line | 20259 LORAIN RD APT 201
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-3526
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Country | US
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Telephone | 216-956-6973
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | S.1600080
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License Number State | OH
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