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NPI Code Detail

MEDICARE: MR. CLOVER ENGLISH III LISW

MEDICARE:  MR. CLOVER  ENGLISH III  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 WorkerI10021OH

General Provider Information

NPI Number : 1932324787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CLOVER ENGLISH III LISW
Provider Business Mailing Address
First Line : 2490 LEE BLVD
Second Line : SUITE 320
City : CLEVELAND HTS
State : OH
Zip : 44118-1268
Country : US
Telephone Number : 216-371-1991
Fax Number :
Provider Business Practice Location Address
First Line : 2490 LEE BLVD
Second Line : SUITE 102
City : CLEVELAND HTS
State : OH
Zip : 44118-1268
Country : US
Telephone Number : 216-371-1991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 12/04/2012

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Directions to “ MR. CLOVER ENGLISH III LISW” Practice Location

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