Provider Demographics
NPI:1245538461
Name:KIRCHICK, CAREN MICHELLE (MSW, LISW-S)
Entity type:Individual
Prefix:MRS
First Name:CAREN
Middle Name:MICHELLE
Last Name:KIRCHICK
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28790 CHAGRIN BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4642
Mailing Address - Country:US
Mailing Address - Phone:440-734-7954
Mailing Address - Fax:216-896-0735
Practice Address - Street 1:28790 CHAGRIN BLVD STE 260
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4642
Practice Address - Country:US
Practice Address - Phone:440-734-7954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00095071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical