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NPI Code Detail

MEDICARE: CLEVELAND SEX & INTIMACY COUNSELING

MEDICARE: CLEVELAND SEX & INTIMACY COUNSELING
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
1101YM0800XMental Health Counselor
2103TC0700XClinical Psychologist
31041C0700XClinical Social Worker

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 : 1982203246
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND SEX & INTIMACY COUNSELING
Provider Business Mailing Address
First Line : 3500 LORAIN AVE STE 301
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3726
Country : US
Telephone Number : 216-250-1607
Fax Number :
Provider Business Practice Location Address
First Line : 3500 LORAIN AVE STE 301
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3726
Country : US
Telephone Number : 216-250-1607
Fax Number : 216-304-6669
Authorized Official
Title or Position : CEO
Name : KIMBERLY A FULLER
Credential : PH.D., LISW-S
Telephone Number : 440-823-6010
Provider Enumeration Date : 10/19/2020
Last Update Date : 09/06/2023

Similar Medicare Providers

1184554925 — DYLAN HACKNEY CT
Practice Location Address:
3500 LORAIN AVE STE 407
CLEVELAND, OH
44113-3726
Practice Phone: 216-250-1607
Practice Fax: 216-304-6669
1538489091 — EMILY ROLL MSSA, LISW-S
Practice Location Address:
3500 LORAIN AVE STE 407
CLEVELAND, OH
44113-3726
Practice Phone: 216-200-8543
Practice Fax: 216-744-1114
1083053375 — DR. KIMBERLY A FULLER LISW-S
Practice Location Address:
3500 LORAIN AVE STE 407
CLEVELAND, OH
44113-3726
Practice Phone: 216-250-1607
Practice Fax: 216-304-6669
1972020790 — JESSIE ALLAN LEU
Practice Location Address:
3500 LORAIN AVE STE 407
CLEVELAND, OH
44113-3726
Practice Phone: 216-250-1607
Practice Fax: 216-304-6669
1912426230 — SAMUEL ELLIOTT BERNHOFER LPCC
Practice Location Address:
3500 LORAIN AVE STE 300
CLEVELAND, OH
44113-3726
Practice Phone: 216-630-4658
Practice Fax:
1518579101 — ELLIOT CARSON WILLIAMS LSW
Practice Location Address:
3500 LORAIN AVE STE 300
CLEVELAND, OH
44113-3726
Practice Phone: 216-250-1607
Practice Fax: 216-304-6669

Directions to “CLEVELAND SEX & INTIMACY COUNSELING ” Practice Location

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