Organization
ELIZABETH KUSON LISW-S, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH KUSON LISW-S (OWNER/THERAPIST)
(330) 221-5951
Entity
Organization
Contact information
Practice address
355 W PROSPECT RD STE 116C, ASHTABULA, OH 44004-5830
(330) 221-5951
Mailing address
6322 TRUMBULL RD, GENEVA, OH 44041-9333
(330) 221-5951
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619351087
INDIVIDUAL NPI
OH
Enumeration date
07/31/2020
Last updated
07/31/2020
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