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NPI Code Detail

MEDICARE: MRS. VALERIE L SISSON LISW-SUPV

MEDICARE: MRS. VALERIE L SISSON LISW-SUPV
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.0008254-SUPVOH

Other Identifiers

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

General Provider Information

NPI Number : 1811293798
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VALERIE L SISSON LISW-SUPV
Provider Business Mailing Address
First Line : 13422 KINSMAN RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44120-4410
Country : US
Telephone Number : 216-283-4400
Fax Number : 216-283-8740
Provider Business Practice Location Address
First Line : 13422 KINSMAN RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44120-4410
Country : US
Telephone Number : 216-283-4400
Fax Number : 216-283-8740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2011
Last Update Date : 03/29/2017

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