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General NPI Number Information
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NPI Number | 1821605635
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Entity Type | Individual
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Provider Name | STEPHANIE KEMP LISW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 18780 BAGLEY RD
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City | CLEVELAND
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State | OH
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Zip | 44130-3303
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Country | US
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Telephone | 404-816-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 25700 SCIENCE PARK DR STE 200
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City | BEACHWOOD
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State | OH
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Zip | 44122-7328
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Country | US
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Telephone | 216-831-1040
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Fax | 216-831-2667
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2506439
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License Number State | OH
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