Provider Demographics
NPI:1164288718
Name:ABRAHAM, DANIEL (LSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4285 SOM CENTER RD
Mailing Address - Street 2:
Mailing Address - City:MORELAND HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2313
Mailing Address - Country:US
Mailing Address - Phone:216-308-8403
Mailing Address - Fax:
Practice Address - Street 1:7000 EUCLID AVE STE 202
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4003
Practice Address - Country:US
Practice Address - Phone:216-391-0264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1201349104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker