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NPI Code Detail

MEDICARE: YASENKA GOVERDOVSKI LISW

MEDICARE: YASENKA GOVERDOVSKI 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1104034891
Entity Type Code : Individual
Provider Name (Legal Business Name) : YASENKA GOVERDOVSKI LISW
Provider Business Mailing Address
First Line : 12900 LAKE AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-1577
Country : US
Telephone Number : 216-228-6590
Fax Number :
Provider Business Practice Location Address
First Line : 3600 FRANKLIN BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-2831
Country : US
Telephone Number : 216-651-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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Directions to “ YASENKA GOVERDOVSKI LISW” Practice Location

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