Provider Demographics
NPI:1124726997
Name:YAVORNITZKY, SHELLEY L (LISW-S)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:L
Last Name:YAVORNITZKY
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 1:41201 SCHADDEN RD
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-2249
Mailing Address - Country:US
Mailing Address - Phone:440-324-0487
Mailing Address - Fax:440-324-0487
Practice Address - Street 1:41201 SCHADDEN RD
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2249
Practice Address - Country:US
Practice Address - Phone:440-324-0487
Practice Address - Fax:440-324-0487
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00076801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical