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NPI Code Detail

MEDICARE: DAVID GRETICK LISW-S

MEDICARE: DAVID GRETICK 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 WorkerI19865OH

General Provider Information

NPI Number : 1760926414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID GRETICK LISW-S
Provider Business Mailing Address
First Line : 3171 W 142ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-1406
Country : US
Telephone Number : 216-501-2792
Fax Number :
Provider Business Practice Location Address
First Line : 2554 W 25TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-4700
Country : US
Telephone Number : 216-781-2250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2016
Last Update Date : 09/11/2025

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Directions to “ DAVID GRETICK LISW-S” Practice Location

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