Elizabeth A Bruot, LSW
Individual provider Active NPI Social Worker · Amherst, OH
NPI 1144312752 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1144312752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- I 3129 (OH)
- Practice address
- 150 Erie CT
Amherst, OH 44001-1724 - Phone
- (440) 984-2416
- Fax
- (440) 984-2422
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I 3129 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Childrens Developmental Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | I 3129 | OH | Yes |
Addresses
Primary practice location
150 Erie CT
Amherst, OH 44001-1724
Mailing address
150 Erie CT
Amherst, OH 44001-1724
Phone (440) 984-2416
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7255198 | Medicaid | OH |
Other providers in Amherst, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.