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NPI Code Detail

MEDICARE: CARLENE L KOVACH

MEDICARE: CARLENE L KOVACH
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
1101YP2500XProfessional CounselorE0007559OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E0007559OTHEROHPCC-S

General Provider Information

NPI Number : 1497076822
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLENE L KOVACH
Provider Business Mailing Address
First Line : 3929 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-4153
Country : US
Telephone Number : 216-252-5800
Fax Number : 216-252-9055
Provider Business Practice Location Address
First Line : 3929 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-4153
Country : US
Telephone Number : 216-252-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2010
Last Update Date : 06/21/2024

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Directions to “ CARLENE L KOVACH ” Practice Location

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