Jeffrey P Land Lisw-S LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0001755-SUPV Issued in OH

Legal business name

JEFFREY P LAND LISW-S LLC

Practice address

6449 Wilson Mills Rd
Mayfield Village, OH 44143-3443

Phone

(440) 442-8800

Fax

(440) 442-8804

NPI assigned

Feb 11, 2014

Last updated

Feb 11, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey Peter Land

Title

Sole MBR

Phone

(440) 251-0237

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1093139057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7048 BENTLEY PL",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440772212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6449 WILSON MILLS RD",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433443",
            "telephone_number": "440-442-8800",
            "fax_number": "440-442-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY P LAND LISW-S LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "LAND",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "440-251-0237"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0001755-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12624773",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Mayfield Village, OH
• Providers in Mayfield Village, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.