Provider Demographics
NPI:1649394958
Name:BROCHUE, SYLVIA (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:
Last Name:BROCHUE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:OLASZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:10100 ELIDA RD.
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:44583
Mailing Address - Country:US
Mailing Address - Phone:419-695-8010
Mailing Address - Fax:
Practice Address - Street 1:20600 CHAGRIN BLVD., #900
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-295-7239
Practice Address - Fax:216-295-7240
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0600529104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1.0800241.SUPVOtherLISW-S