Provider Demographics
NPI:1518046911
Name:SHUBERT, ALAN NEAL (LISW)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:NEAL
Last Name:SHUBERT
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14843 W SPRAGUE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-6601
Mailing Address - Country:US
Mailing Address - Phone:440-234-9955
Mailing Address - Fax:440-234-5994
Practice Address - Street 1:14843 W SPRAGUE RD
Practice Address - Street 2:SUITE A
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6601
Practice Address - Country:US
Practice Address - Phone:440-234-9955
Practice Address - Fax:440-234-5994
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0003291041C0700X
OHI 0003291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty