Individual ProviderMichael McdonnellSocial WorkerBehavioral Health & Social Service ProvidersPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118(216) 932-6152PECOS EnrollmentBased on the most recent information from CMS, provider Michael Mcdonnell 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 ID1225442437Provider TypeIndividualFull NameMcdonnell, MichaelGenderMaleSole ProprietorNoEnumeration Date6/16/2014Last Updated7/10/2018Contact InformationPractice LocationPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118Phone(216) 932-6152FaxUnlisted FaxMailing LocationMailing Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819Phone(216) 932-6152FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseI.1800770OhioCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseS.1450279OhioProvider IdentifiersIDDescriptionIssuerID1473276DescriptionMedicaidIssuerUnlistedOhio