MEDICARE: MS. MARIA MICHALOPOULOS L.I.S.W.

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	101YM0800X	Mental Health Counselor	I7833	OH

General Provider Information

NPI Number	:	1225071764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA MICHALOPOULOS L.I.S.W.

Provider Business Mailing Address
First Line	:	24551 DETROIT RD
Second Line	:	STE 5
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2592
Country	:	US
Telephone Number	:	216-374-8029
Fax Number	:

Provider Business Practice Location Address
First Line	:	24551 DETROIT RD
Second Line	:	STE 5
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2592
Country	:	US
Telephone Number	:	216-374-8029
Fax Number	:

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	01/22/2017

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