Provider Demographics
NPI:1528595758
Name:WOODS, DONNA LILLIAN (LSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LILLIAN
Last Name:WOODS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1276 W 3RD ST STE 210
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1512
Mailing Address - Country:US
Mailing Address - Phone:216-443-8250
Mailing Address - Fax:
Practice Address - Street 1:1276 W 3RD ST STE 210
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1512
Practice Address - Country:US
Practice Address - Phone:216-443-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH292062Medicaid