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General NPI Number Information
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NPI Number | 1700342177
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Entity Type | Individual
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Provider Name | KEITH O SEWARD CDCA
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Gender | Male
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 3746 PROSPECT AVE E
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City | CLEVELAND
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State | OH
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Zip | 44115-2706
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Country | US
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Telephone | 216-391-6672
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Fax |
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Provider Business Mailing Address
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Address Line | 3781 NORTHWOOD RD
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City | UNIVERSITY HT
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State | OH
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Zip | 44118-3737
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Country | US
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Telephone | 216-470-7937
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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 | CDCA.169227
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License Number State | OH
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