MEDICARE: SUZANNE HARRINGTON LISW

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	1041C0700X	Clinical Social Worker	I.0007706-S	OH
2	1041C0700X	Clinical Social Worker	I.0007706	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000244878	OTHER	OH	ANTHEM BLUE CROSS PIN

General Provider Information

NPI Number	:	1548289226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE HARRINGTON LISW

Provider Business Mailing Address
First Line	:	5010 MAYFIELD RD STE 105
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2611
Country	:	US
Telephone Number	:	216-970-5404
Fax Number	:

Provider Business Practice Location Address
First Line	:	5010 MAYFIELD RD STE 105
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2611
Country	:	US
Telephone Number	:	216-970-5404
Fax Number	:

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	04/30/2023

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Directions to “ SUZANNE HARRINGTON LISW” Practice Location

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