MEDICARE: SHERRI ANN SKEDEL LISW-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I0030734	OH

General Provider Information

NPI Number	:	1003940859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRI ANN SKEDEL LISW-S

Provider Business Mailing Address
First Line	:	18227 VAN AKEN BLVD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-4823
Country	:	US
Telephone Number	:	216-630-2255
Fax Number	:

Provider Business Practice Location Address
First Line	:	2843 WASHINGTON BLVD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2009
Country	:	US
Telephone Number	:	216-320-4780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	12/30/2015

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