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General NPI Number Information
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NPI Number | 1912299306
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Entity Type | Individual
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Provider Name | LAUREL GREENE KAISER LISW
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Gender | Female
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 25201 CHAGRIN BLVD STE 390
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City | BEACHWOOD
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State | OH
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Zip | 44122-5637
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Country | US
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Telephone | 216-282-7244
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 ACACIA PARK DR 2105
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City | LYNDHURST
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State | OH
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Zip | 44124-3865
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Country | US
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Telephone | 216-269-8597
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I1500245
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License Number State | OH
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