Individual
EDWIN R SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
10524 EUCLID AVE FL 12, CLEVELAND, OH 44106-2205
(216) 844-2400
(216) 844-2877
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5288
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224328
UNISON
OH
01
—
000000532989
ANTHEM
OH
05
—
2126425
—
OH
01
—
364008
WELLCARE MEDICAID
OH
01
—
620006108
RAILROAD MEDICARE
OH
01
—
7310626
AETNA
OH
Enumeration date
07/20/2006
Last updated
01/06/2021
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