Glenda J. Kupersmith | Willoughby, OH • PECOS Search

Glenda J. Kupersmith

Social Worker

Behavioral Health & Social Service Providers

34950 Chardon Rd, Ste. 202, Willoughby, OH 44094-9162

(440) 510-5100 (440) 442-1431

PECOS Enrollment

Based on the most recent information from CMS, provider Glenda J. Kupersmith 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 4 days ago.

Profile Details

Provider ID
1861569840
Provider Type
Individual
Full Name
Kupersmith, Glenda J.
Title
Ms.
Credential
LISW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/29/2006
Last Updated
7/8/2007

Contact Information

Practice Location

34950 Chardon Rd, Ste. 202, Willoughby, OH 44094-9162

(440) 510-5151

Mailing Location

30800 Gates Mills Blvd, Pepper Pike, OH 44124-4370

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License I 0007108 Ohio