Provider Demographics
NPI:1235894981
Name:POGGI, ELISA (MSW LSW)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:POGGI
Suffix:
Gender:F
Credentials:MSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 HUNTING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2264
Mailing Address - Country:US
Mailing Address - Phone:216-832-6606
Mailing Address - Fax:216-342-1110
Practice Address - Street 1:23625 COMMERCE PARK STE 180
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5847
Practice Address - Country:US
Practice Address - Phone:216-526-1843
Practice Address - Fax:216-342-1110
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00198841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical