Organization
JODY WAINER INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JODY WAINER LISW (PRESIDENT)
(216) 464-6705
Entity
Organization
Contact information
Practice address
3601 GREEN RD, SUITE 200, BEACHWOOD, OH 44122-5725
(216) 464-6705
Mailing address
3601 GREEN RD, SUITE 200, BEACHWOOD, OH 44122-5725
(216) 464-6705
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000385
LICENSED INDEPENDENT SOCIAL WORKER
OH
01
—
1558366831
NPI
OH
01
—
SW22641
PTAN
OH
Enumeration date
04/25/2008
Last updated
04/25/2008
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