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Simona A Mkrtschjan

Social Worker

Behavioral Health & Social Service Providers

2815 Corydon Rd, Cleveland Heights, OH 44118-3511

PECOS Enrollment

Based on the most recent information from CMS, provider Simona A Mkrtschjan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1710283999
Provider Type
Individual
Full Name
Mkrtschjan, Simona A
Title
Ms.
Credential
LISW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/4/2011
Last Updated
6/6/2012

Contact Information

Practice Location

2815 Corydon Rd, Cleveland Heights, OH 44118-3511

(617) 803-5317

Unlisted Fax

Mailing Location

2815 Corydon Rd, Cleveland Heights, OH 44118-3511

(617) 803-5317

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License I.1200004 Ohio

Provider Identifiers

ID	Description	Issuer
ID 0268768	Description Medicaid	Issuer Unlisted Ohio

Simona A Mkrtschjan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Anderson, Karen J.

Daddona, Megan Elizabeth

Criss, Elfrida

Schaumburg, Nancy Susan

Appel, Suzanne

O'Connor, Kelly

Gavalya, Theresa Marie

Carey, Faith Anastasia

Grant, Ashly

Tyson, Amy Phelan Smith