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NPI Code Detail

MEDICARE: MS. LINDA ANN HERBERT LISW-S

MEDICARE: MS. LINDA ANN HERBERT LISW-S
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 WorkerI 0007440 SUPVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1I 0007440 SUPVOTHEROHCOUNSELOR AND SOCIAL WORKER BOARD LICENSE STATE OF OHIO

General Provider Information

NPI Number : 1750546107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA ANN HERBERT LISW-S
Provider Business Mailing Address
First Line : 300 E 185TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44119-1330
Country : US
Telephone Number : 216-383-2222
Fax Number :
Provider Business Practice Location Address
First Line : 300 E 185TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44119-1330
Country : US
Telephone Number : 216-383-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2008
Last Update Date : 07/25/2008

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Directions to “ MS. LINDA ANN HERBERT LISW-S” Practice Location

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