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NPI Code Detail

MEDICARE: RACHEL HUMPHREY LISW

MEDICARE: RACHEL HUMPHREY 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
11041C0700XClinical Social WorkerI1440454OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740698810
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL HUMPHREY LISW
Provider Business Mailing Address
First Line : 13201 GRANGER RD
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1978
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13201 GRANGER RD
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1978
Country : US
Telephone Number : 216-831-2255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2014
Last Update Date : 08/01/2024

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Directions to “ RACHEL HUMPHREY LISW” Practice Location

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