Glenda J. Kupersmith, LISW
Individual provider Active NPI Clinical Social Worker · Willoughby, OH
NPI 1861569840 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1861569840
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I 0007108 (OH)
- Practice address
- 34950 Chardon Rd
Ste. 202
Willoughby, OH 44094-9162 - Phone
- (440) 510-5100
- Fax
- (440) 510-5151
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I 0007108 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Reserve Counseling Service, Inc. | Past | Accepting new patients | |
| Pathways Inc | Past | Accepting new patients | |
| Pathways Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I 0007108 | OH | Yes |
Addresses
Primary practice location
34950 Chardon Rd
Ste. 202
Willoughby, OH 44094-9162
Mailing address
30800 Gates Mills Blvd
Pepper Pike, OH 44124-4370
Phone (440) 442-1431
Other providers in Willoughby, OH
- Trudy Kucharski
- David P Kucmanic
- Lisa Kuhen
- Lynn Kuhnle
- Mark Kun
- Margarita Kutsikovich
- Heather Community Kwedder
- Laboratory Corporation of America Holdings
- Linda Lack
- Joann Lagman
All providers in Willoughby, OH · Clinical Social Worker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 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.