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NPI Code Detail

MEDICARE: HELEN M HAAGEN LSW, LICDC

MEDICARE: HELEN M HAAGEN LSW, LICDC
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) CounselorLICDC.162112OH
2104100000XSocial WorkerS.1401372OH

General Provider Information

NPI Number : 1386143725
Entity Type Code : Individual
Provider Name (Legal Business Name) : HELEN M HAAGEN LSW, LICDC
Provider Business Mailing Address
First Line : 434 EASTLAND RD
Second Line :
City : BEREA
State : OH
Zip : 44017-1217
Country : US
Telephone Number : 440-260-8300
Fax Number : 440-234-8319
Provider Business Practice Location Address
First Line : 3500 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2641
Country : US
Telephone Number : 440-260-8300
Fax Number : 440-234-8319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2018
Last Update Date : 04/22/2026

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