Provider Demographics
NPI:1558819789
Name:MESFIN, YILAK A (LSW)
Entity type:Individual
Prefix:MR
First Name:YILAK
Middle Name:A
Last Name:MESFIN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4882 GERALDINE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2858
Mailing Address - Country:US
Mailing Address - Phone:440-381-4627
Mailing Address - Fax:
Practice Address - Street 1:4882 GERALDINE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2858
Practice Address - Country:US
Practice Address - Phone:440-381-4627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600899104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker