Provider Demographics
NPI:1629563507
Name:SCRUDDERS, CARA (LSW)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:SCRUDDERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:MENNINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3690 ORANGE PL STE 320
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4432
Mailing Address - Country:US
Mailing Address - Phone:216-831-1494
Mailing Address - Fax:216-831-9931
Practice Address - Street 1:3690 ORANGE PL STE 320
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4432
Practice Address - Country:US
Practice Address - Phone:216-831-1494
Practice Address - Fax:216-831-9931
Is Sole Proprietor?:No
Enumeration Date:2018-06-24
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1802616104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker