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General NPI Number Information
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NPI Number | 1780439596
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Entity Type | Individual
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Provider Name | NICHOLE MCCROSKEY LSW
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Gender | Female
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 25701 N LAKELAND BLVD STE 403
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City | EUCLID
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State | OH
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Zip | 44132-2453
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Country | US
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Telephone | 216-273-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 3772 THURGOOD AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-3095
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Country | US
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Telephone | 404-426-0637
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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 | S.2207451
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License Number State | OH
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