Provider Demographics
NPI:1063594000
Name:CORE, HARRY MICHAEL (LISW MSW)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:MICHAEL
Last Name:CORE
Suffix:
Gender:M
Credentials:LISW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 MENTOR AVENUE
Mailing Address - Street 2:STE 320
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-8712
Mailing Address - Country:US
Mailing Address - Phone:440-639-1221
Mailing Address - Fax:440-639-1112
Practice Address - Street 1:9500 MENTOR AVENUE
Practice Address - Street 2:STE 320
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-8712
Practice Address - Country:US
Practice Address - Phone:440-639-1221
Practice Address - Fax:440-639-1112
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00004341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical