Individual ProviderLouise Gottlob CullenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address35000 Chardon Rd #210, Diane Eden Md And Assoc., Willoughby Hills, OH 44094(440) 951-5600PECOS EnrollmentBased on the most recent information from CMS, provider Louise Gottlob Cullen is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1104888569Provider TypeIndividualFull NameGottlob Cullen, LouiseTitleMrs.CredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date4/3/2006Last Updated6/7/2024Contact InformationPractice LocationPractice Address35000 Chardon Rd #210, Diane Eden Md And Assoc., Willoughby Hills, OH 44094Phone(440) 951-5600Fax(440) 951-1293Mailing LocationMailing Address35000 Chardon Rd #210, Diane Eden Md And Assoc., Willoughby Hills, OH 44094Phone(440) 951-5600Fax(440) 951-1293Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseLISW-19236ArizonaCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense7128Ohio