Provider Demographics
NPI:1346713757
Name:NOVAK, MUNEERA Y (LISW)
Entity type:Individual
Prefix:
First Name:MUNEERA
Middle Name:Y
Last Name:NOVAK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:MUNEERA
Other - Middle Name:B
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, LISW
Mailing Address - Street 1:26470 SHOREVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29201 AURORA RD STE 400
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-1846
Practice Address - Country:US
Practice Address - Phone:440-567-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1803277104100000X
OHI.23047641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker