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NPI Code Detail

MEDICARE: SYLVIA JOHNSON-LEE LISW-S

MEDICARE: SYLVIA JOHNSON-LEE LISW-S
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
1101YA0400XAddiction (Substance Use Disorder) Counselor991589OH
21041C0700XClinical Social WorkerI. 1200720OH

General Provider Information

NPI Number : 1326452814
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYLVIA JOHNSON-LEE LISW-S
Provider Business Mailing Address
First Line : 1905 E 89TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2007
Country : US
Telephone Number : 216-231-3772
Fax Number : 216-231-5040
Provider Business Practice Location Address
First Line : 1905 E 89TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2007
Country : US
Telephone Number : 216-231-3772
Fax Number : 216-231-5040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2014
Last Update Date : 06/12/2014

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Directions to “ SYLVIA JOHNSON-LEE LISW-S” Practice Location

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