Provider Demographics
NPI:1407216625
Name:SCHWERSENSKI, ELISHEVA (PC)
Entity type:Individual
Prefix:
First Name:ELISHEVA
Middle Name:
Last Name:SCHWERSENSKI
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23293 COMMERCE PARK
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5808
Mailing Address - Country:US
Mailing Address - Phone:216-292-7170
Mailing Address - Fax:216-292-7172
Practice Address - Street 1:23293 COMMERCE PARK
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5808
Practice Address - Country:US
Practice Address - Phone:216-292-7170
Practice Address - Fax:216-292-7172
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1200332101Y00000X, 101YM0800X, 101YP2500X
OHLCDC.151069-3101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional