Provider Demographics
NPI:1952683120
Name:KRAWCZYNSKI, NELLIE (LISW)
Entity Type:Individual
Prefix:MS
First Name:NELLIE
Middle Name:
Last Name:KRAWCZYNSKI
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 1:6507 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44144-1640
Mailing Address - Country:US
Mailing Address - Phone:216-641-5503
Mailing Address - Fax:
Practice Address - Street 1:6929 W 130TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7895
Practice Address - Country:US
Practice Address - Phone:440-842-6867
Practice Address - Fax:440-842-8914
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI11000861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical