| Melissa Pantel-ku Lisw-s Llc | |
|
19910 Malvern Rd Ste 201 Shaker Heights OH 44122-2823 | |
| (440) 227-1955 | |
| Not Available |
| Full Name | Melissa Pantel-ku Lisw-s Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19910 Malvern Rd Ste 201, Shaker Heights, Ohio |
| Authorized Official Name and Position | Melissa Pantel-ku (OWNER/MEMBER) |
| Authorized Official Contact | 4402271955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Pantel-ku Lisw-s Llc 17666 Stockton Ln Chagrin Falls OH 44023-5741 Ph: (440) 227-1955 | Melissa Pantel-ku Lisw-s Llc 19910 Malvern Rd Ste 201 Shaker Heights OH 44122-2823 Ph: (440) 227-1955 |
| NPI Number | 1902512809 |
|---|---|
| Provider Enumeration Date | 01/25/2023 |
| Last Update Date | 05/12/2023 |
| Certification Date | 05/12/2023 |
| Medicare PECOS PAC ID | 1850753005 |
|---|---|
| Medicare Enrollment ID | O20230821000275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902512809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Melissa Pantel-ku |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134686702 PECOS PAC ID: 4284975152 Enrollment ID: I20190403002013 |
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