Provider Demographics
NPI:1649848243
Name:BUDZ, STEFAN K (LSW)
Entity type:Individual
Prefix:MR
First Name:STEFAN
Middle Name:K
Last Name:BUDZ
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 1:1388 LAKELAND AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2450
Mailing Address - Country:US
Mailing Address - Phone:216-396-3466
Mailing Address - Fax:
Practice Address - Street 1:2800 EUCLID AVE STE 200
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2418
Practice Address - Country:US
Practice Address - Phone:216-396-3466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHS.2310027104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty