MEDICARE: THE PERSPECTIVE LIASON CLINICAL CONSULTATION & ENGAGEMENT GROUP

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1649922030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PERSPECTIVE LIASON CLINICAL CONSULTATION & ENGAGEMENT GROUP

Provider Business Mailing Address
First Line	:	2000 LEE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2572
Country	:	US
Telephone Number	:	440-291-3335
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 LEE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2572
Country	:	US
Telephone Number	:	440-291-3335
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE LEWIS
Credential	:
Telephone Number	:	213-820-5225

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	01/26/2022

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