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NPI Code Detail

MEDICARE: LISA A. CLEAVER

MEDICARE: LISA A. CLEAVER
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 CounselorPC000242PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11661860OTHERPAPERSONAL CHOICE
22322127000OTHERPAMHS
37170583OTHERPAAETNA

General Provider Information

NPI Number : 1619981750
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA A. CLEAVER
Provider Business Mailing Address
First Line : 100 LEVITTOWN PKWY
Second Line :
City : LEVITTOWN
State : PA
Zip : 19054-3502
Country : US
Telephone Number : 215-945-2550
Fax Number : 216-945-3595
Provider Business Practice Location Address
First Line : 100 LEVITTOWN PKWY
Second Line :
City : LEVITTOWN
State : PA
Zip : 19054-3502
Country : US
Telephone Number : 215-945-2550
Fax Number : 216-945-3595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/08/2007

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