Provider Demographics
NPI:1952915621
Name:PRIESTLY, APRIL MARIE (LSW)
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:MARIE
Last Name:PRIESTLY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:APRIL
Other - Middle Name:
Other - Last Name:PRIESTLY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:3626 PENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-5066
Mailing Address - Country:US
Mailing Address - Phone:216-414-4959
Mailing Address - Fax:
Practice Address - Street 1:3626 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-5066
Practice Address - Country:US
Practice Address - Phone:216-414-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1000933104100000X
OHRL003805104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty