Provider Demographics
NPI:1427027606
Name:DAVIDSON, ADINA RUTH (PHD LISW)
Entity Type:Individual
Prefix:DR
First Name:ADINA
Middle Name:RUTH
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:PHD LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 WINCHELL RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-721-8123
Mailing Address - Fax:216-432-0770
Practice Address - Street 1:12429 CEDAR ROAD
Practice Address - Street 2:SUITE 21
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-721-8123
Practice Address - Fax:216-432-0770
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0007368104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker