Provider Demographics
NPI:1033462122
Name:LI, CHENMI
Entity Type:Individual
Prefix:
First Name:CHENMI
Middle Name:
Last Name:LI
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 1:12000 FAIRHILL RD
Mailing Address - Street 2:APT 222
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12000 FAIRHILL RD
Practice Address - Street 2:APT 222
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1035
Practice Address - Country:US
Practice Address - Phone:216-785-8852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
S,1202223-TRNE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical