MEDICARE: LINDA G CRAFT LISW

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	101YP2500X	Professional Counselor	E.0003206-SUPV	OH

General Provider Information

NPI Number	:	1033547492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA G CRAFT LISW

Provider Business Mailing Address
First Line	:	25101 CHAGRIN BLVD
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5643
Country	:	US
Telephone Number	:	216-831-6611
Fax Number	:	216-456-8128

Provider Business Practice Location Address
First Line	:	7185 LIBERTY CENTRE DR
Second Line	:	SUITE D
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45069-6586
Country	:	US
Telephone Number	:	513-504-9310
Fax Number	:	513-847-6365

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

Provider Enumeration Date	:	10/23/2013
Last Update Date	:	03/23/2016

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Directions to “ LINDA G CRAFT LISW” Practice Location

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