Provider Demographics
NPI:1235141300
Name:MARCIANO, CAROLE M (LISW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:M
Last Name:MARCIANO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24400 HIGHPOINT ROAD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-831-2500
Mailing Address - Fax:216-831-4035
Practice Address - Street 1:BEHAVIORAL HEALTH ASSOCIATES
Practice Address - Street 2:2400 HIGHPOINT ROAD
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-831-2500
Practice Address - Fax:216-831-4035
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI7148104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH936562Medicare ID - Type Unspecified