MEDICARE: CELIA JOYCE LSW

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	104100000X	Social Worker	S.1201326	OH

General Provider Information

NPI Number	:	1164997367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELIA JOYCE LSW

Provider Business Mailing Address
First Line	:	6753 STATE RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-4517
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 ALAMEDA AVE
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4934
Country	:	US
Telephone Number	:	216-592-2898
Fax Number	:

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

Provider Enumeration Date	:	10/04/2018
Last Update Date	:	10/04/2018

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Directions to “ CELIA JOYCE LSW” Practice Location

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