Individual ProviderMickie ChaneySocial WorkerBehavioral Health & Social Service ProvidersPractice Address5 Severance Cir Ste 201, Cleveland Hts, OH 44118-1567(216) 659-5406(216) 224-1261PECOS EnrollmentBased on the most recent information from CMS, provider Mickie Chaney 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 ID1922508159Provider TypeIndividualFull NameChaney, MickieGenderFemaleSole ProprietorNoEnumeration Date2/14/2018Last Updated1/24/2023Contact InformationPractice LocationPractice Address5 Severance Cir Ste 201, Cleveland Hts, OH 44118-1567Phone(216) 659-5406FaxUnlisted FaxMailing LocationMailing Address13701 5th Ave, East Cleveland, OH 44112-3109Phone(216) 224-1261FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseI.1801289OhioCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer