=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902297476
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | H ROSS LOWENSTEIN INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2015
-----------------------------------------------------
Last Update Date | 02/05/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29525 CHAGRIN BLVD STE 303
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-4601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-464-4664
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29525 CHAGRIN BLVD STE 303
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-4601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-464-4664
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TAX ID OWNER
-----------------------------------------------------
Name | HEATHER ROSS LOWENSTEIN
-----------------------------------------------------
Credential | LISW
-----------------------------------------------------
Telephone | 216-464-4664
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0003773
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------