Provider Demographics
NPI:1275171399
Name:BEATO, MARTINA ((SWT))
Entity Type:Individual
Prefix:
First Name:MARTINA
Middle Name:
Last Name:BEATO
Suffix:
Gender:F
Credentials:(SWT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 W 37TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2304
Mailing Address - Country:US
Mailing Address - Phone:440-222-9026
Mailing Address - Fax:
Practice Address - Street 1:THE NORD CENTER 6140 S. BROADWAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053
Practice Address - Country:US
Practice Address - Phone:440-233-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1900835-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker