MEDICARE: FRANCES ANN HELUSKY 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	I9869	OH

General Provider Information

NPI Number	:	1215128772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES ANN HELUSKY LISW

Provider Business Mailing Address
First Line	:	1721 HAWTHORNE DR
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-3023
Country	:	US
Telephone Number	:	440-442-8806
Fax Number	:	440-442-8806

Provider Business Practice Location Address
First Line	:	1721 HAWTHORNE DR
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-3023
Country	:	US
Telephone Number	:	440-442-8806
Fax Number	:	440-442-8806

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

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	08/08/2007

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