| Yvette Goldurs, Lisw, Llc | |
|
21380 Lorain Rd Ste 102 Fairview Park OH 44126-2144 | |
| (216) 526-4208 | |
| (216) 274-6388 |
| Full Name | Yvette Goldurs, Lisw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 21380 Lorain Rd Ste 102, Fairview Park, Ohio |
| Authorized Official Name and Position | Yvette Goldurs (OWNER) |
| Authorized Official Contact | 2165264208 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yvette Goldurs, Lisw, Llc 3867 Glenwood Rd Cleveland Heights OH 44121-1649 Ph: (216) 526-4208 | Yvette Goldurs, Lisw, Llc 21380 Lorain Rd Ste 102 Fairview Park OH 44126-2144 Ph: (216) 526-4208 |
| NPI Number | 1598327751 |
|---|---|
| Provider Enumeration Date | 07/08/2019 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Medicare PECOS PAC ID | 0840528022 |
|---|---|
| Medicare Enrollment ID | O20190826003380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598327751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Yvette M Goldurs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992058267 PECOS PAC ID: 3476705401 Enrollment ID: I20121220000085 |
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