MEDICARE: MRS. MARY KATHRYN LAWSON L.I.S.W.

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
1	1041C0700X	Clinical Social Worker	I-0005093	OH

General Provider Information

NPI Number	:	1881706448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY KATHRYN LAWSON L.I.S.W.

Provider Business Mailing Address
First Line	:	20575 CENTER RIDGE RD
Second Line	:	STE 314
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-3422
Country	:	US
Telephone Number	:	440-331-4533
Fax Number	:	440-331-5244

Provider Business Practice Location Address
First Line	:	20575 CENTER RIDGE RD
Second Line	:	STE 314
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-3422
Country	:	US
Telephone Number	:	440-331-4533
Fax Number	:	440-331-5244

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/05/2021

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