Individual
DR. WILLIAM L. MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD., LISW-S, LICDC,
Contact information
Practice address
14650 DETROIT AVENUE, SUITE LL40, LAKEWOOD, OH 44107
(216) 226-2721
(216) 226-2731
Mailing address
14650 DETROIT AVENUE, SUITE LL40, LAKEWOOD, OH 44107
(216) 226-2721
(216) 226-2731
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
78002
OH
103TC0700X
Clinical Psychologist
Primary
3670
OH
1041C0700X
Clinical Social Worker
I0002480
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0274297
—
OH
Enumeration date
06/21/2006
Last updated
12/13/2011
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