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General NPI Number Information
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NPI Number | 1760849749
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Entity Type | Individual
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Provider Name | CHRISTI SETH LISW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5021 STATE RD
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City | ASHTABULA
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State | OH
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Zip | 44004-6265
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Country | US
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Telephone | 440-354-7364
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Fax | 440-536-5865
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Provider Business Mailing Address
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Address Line | 1228 EUCLID AVE SUITE 200
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City | CLEVELAND
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State | OH
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Zip | 44115-1834
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Country | US
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Telephone | 216-619-6194
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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 | SW131514
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S1500143
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW019673
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1700689
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License Number State | OH
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