Provider Demographics
NPI:1003703836
Name:MI, YAN
Entity type:Individual
Prefix:
First Name:YAN
Middle Name:
Last Name:MI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 WOODMERE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3653
Mailing Address - Country:US
Mailing Address - Phone:216-258-5029
Mailing Address - Fax:
Practice Address - Street 1:23611 CHAGRIN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5540
Practice Address - Country:US
Practice Address - Phone:888-442-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2512441104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker