=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831498880
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROCHELL UREAL LINDSEY LSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2011
-----------------------------------------------------
Last Update Date | 06/01/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 165 E PARK AVE
-----------------------------------------------------
City | NILES
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-544-0805
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 199 HAMILTON AVE
-----------------------------------------------------
City | CAMPBELL
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44405-1866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-272-1522
-----------------------------------------------------
Fax | 330-272-1522
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | S.0600910
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------