Provider Demographics
NPI:1609265909
Name:VON CARLOWITZ, GENEVIEVE (LISW)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:VON CARLOWITZ
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11606 EDGEPARK DR
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2838
Mailing Address - Country:US
Mailing Address - Phone:614-572-8872
Mailing Address - Fax:
Practice Address - Street 1:6929 W 130TH ST STE 307
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7822
Practice Address - Country:US
Practice Address - Phone:440-887-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-10
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1451290104100000X
OHI.2002180104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker