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General NPI Number Information
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NPI Number | 1235397001
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Entity Type | Individual
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Provider Name | CAROL HALES LISW
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Gender | Female
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 3690 ORANGE PL SUITE 330
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City | BEACHWOOD
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State | OH
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Zip | 44122-4464
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Country | US
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Telephone | 216-464-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 W STATE ST
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City | ALLIANCE
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State | OH
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Zip | 44601-4626
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | I-0000452
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License Number State | OH
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