Provider Demographics
NPI:1821052036
Name:AVIV, LUISA (LISW)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:AVIV
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 1:24800 HIGHPOINT RD
Mailing Address - Street 2:STE. B
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6052
Mailing Address - Country:US
Mailing Address - Phone:216-831-6611
Mailing Address - Fax:440-944-7330
Practice Address - Street 1:24800 HIGHPOINT RD
Practice Address - Street 2:STE. B
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6052
Practice Address - Country:US
Practice Address - Phone:216-831-6611
Practice Address - Fax:440-944-7330
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4913104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker