MEDICARE: KAREN KREINBERG 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	1041C0700X	Clinical Social Worker	I.0003558-SUPV	OH

General Provider Information

NPI Number	:	1063431765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN KREINBERG LISW

Provider Business Mailing Address
First Line	:	3659 GREEN RD STE 208
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5715
Country	:	US
Telephone Number	:	216-462-0201
Fax Number	:	216-342-4155

Provider Business Practice Location Address
First Line	:	3659 GREEN RD STE 208
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5715
Country	:	US
Telephone Number	:	216-462-0201
Fax Number	:	216-342-4155

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	04/11/2024

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