Provider Demographics
NPI:1366477143
Name:JAMES, FRED ALSTON (LMSW)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:ALSTON
Last Name:JAMES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 PARKHILL DR
Mailing Address - Street 2:APT.19
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-9117
Mailing Address - Country:US
Mailing Address - Phone:330-849-1006
Mailing Address - Fax:
Practice Address - Street 1:3500 SAINT CLAIR AVE NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-4106
Practice Address - Country:US
Practice Address - Phone:216-231-3479
Practice Address - Fax:216-393-5316
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010822031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical