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NPI Code Detail

MEDICARE: EMILY ROLL MSSA, LISW-S

MEDICARE: EMILY ROLL MSSA, 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
11041C0700XClinical Social WorkerI.0900109-SUPVOH

General Provider Information

NPI Number : 1538489091
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ROLL MSSA, LISW-S
Provider Business Mailing Address
First Line : 14618 RAINBOW AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-2221
Country : US
Telephone Number : 440-263-1279
Fax Number :
Provider Business Practice Location Address
First Line : 3500 LORAIN AVE STE 407
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3726
Country : US
Telephone Number : 216-200-8543
Fax Number : 216-744-1114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2010
Last Update Date : 06/29/2024

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Directions to “ EMILY ROLL MSSA, LISW-S” Practice Location

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