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NPI Code Detail

MEDICARE: TUESDAY A SHATTUCK LISW

MEDICARE: TUESDAY A SHATTUCK 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 WorkerI.0007981OH

General Provider Information

NPI Number : 1831131051
Entity Type Code : Individual
Provider Name (Legal Business Name) : TUESDAY A SHATTUCK LISW
Provider Business Mailing Address
First Line : 5255 N ABBE RD
Second Line :
City : SHEFFIELD VILLAGE
State : OH
Zip : 44035-1451
Country : US
Telephone Number : 440-934-9158
Fax Number :
Provider Business Practice Location Address
First Line : 6929 W 130TH ST
Second Line : SUITE 500
City : PARMA HEIGHTS
State : OH
Zip : 44130-7878
Country : US
Telephone Number : 440-842-6867
Fax Number : 440-842-8914
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 02/23/2021

Similar Medicare Providers

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1346286739 — JULIANNA SLATTERY PSY.D.
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1114367075 — DR. JORDAN M JOB DDS
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6929 W 130TH ST STE 600
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1720595135 — MRS. LISA CAROLE DANIELS-KRAVITZ LPD
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Directions to “ TUESDAY A SHATTUCK LISW” Practice Location

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