Provider Demographics
NPI:1215966916
Name:CAHN, KATIE SHINBAUM (LISW)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:SHINBAUM
Last Name:CAHN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21204 HALWORTH RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3868
Mailing Address - Country:US
Mailing Address - Phone:216-991-0862
Mailing Address - Fax:
Practice Address - Street 1:21625 CHAGRIN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5363
Practice Address - Country:US
Practice Address - Phone:216-751-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI15111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCASW30941Medicare ID - Type Unspecified