Basic Information
| Provider Information | |||||||||
| NPI: | 1205884731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAYE | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20600 CHAGRIN BLVD STE 620 | ||||||||
| Address2: | |||||||||
| City: | SHAKER HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441225340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165487850 | ||||||||
| FaxNumber: | 3058919647 | ||||||||
| Practice Location | |||||||||
| Address1: | 20600 CHAGRIN BLVD STE 620 | ||||||||
| Address2: | |||||||||
| City: | SHAKER HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441225340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165487850 | ||||||||
| FaxNumber: | 2167515894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 01/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW 8198 | FL | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | I.1000313-SUPV | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.