Provider Demographics
NPI:1770510224
Name:FALENDER, CAROL M (LISW-S)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:FALENDER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 KEW RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1204
Mailing Address - Country:US
Mailing Address - Phone:216-321-3611
Mailing Address - Fax:216-321-0021
Practice Address - Street 1:5010 MAYFIELD RD
Practice Address - Street 2:SUITE 304
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2695
Practice Address - Country:US
Practice Address - Phone:216-321-3611
Practice Address - Fax:216-321-0021
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00008641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW23161Medicare PIN