MEDICARE: ALEXANDRIA NICOLE SUCHETKA

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1558908129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA NICOLE SUCHETKA

Provider Business Mailing Address
First Line	:	5900 LANDERBROOK DR STE 301
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4020
Country	:	US
Telephone Number	:	216-417-8813
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 LANDERBROOK DR STE 301
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4020
Country	:	US
Telephone Number	:	216-417-8813
Fax Number	:

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

Provider Enumeration Date	:	12/03/2019
Last Update Date	:	08/01/2025

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