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NPI Code Detail

MEDICARE: COLLEEN LYNETTE GRABOWSKI MA, MFCS, PCC-S

MEDICARE: COLLEEN LYNETTE GRABOWSKI MA, MFCS, PCC-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) Counselor001398OH
2101YM0800XMental Health CounselorE-0003471-SUPVOH

General Provider Information

NPI Number : 1467531673
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN LYNETTE GRABOWSKI MA, MFCS, PCC-S
Provider Business Mailing Address
First Line : 3500 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2641
Country : US
Telephone Number : 440-260-8581
Fax Number : 440-260-8576
Provider Business Practice Location Address
First Line : 3500 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2641
Country : US
Telephone Number : 440-260-8581
Fax Number : 440-260-8576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 01/20/2012

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