=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245451632
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCIART, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23240 CHAGRIN BLVD
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-5404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-292-2710
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23240 CHAGRIN BLVD
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-5404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-292-2710
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | DR. NANCY SUE WINKELMAN
-----------------------------------------------------
Credential | M.S.S.A.
-----------------------------------------------------
Telephone | 216-292-3530
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | I3249
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------