MEDICARE: CASEY COLBERT

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	235Z00000X	Speech-Language Pathologist	COND.20253297-SP	OH

General Provider Information

NPI Number	:	1518848431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY COLBERT

Provider Business Mailing Address
First Line	:	50 PUBLIC SQ APT 936
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-2248
Country	:	US
Telephone Number	:	307-630-1467
Fax Number	:

Provider Business Practice Location Address
First Line	:	2160 PAYNE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-4406
Country	:	US
Telephone Number	:	216-838-8000
Fax Number	:

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

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	09/09/2025

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Directions to “ CASEY COLBERT ” Practice Location

Language	Start Address	Practice Location

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