Individual
LACONYA CHARMAINE WITHERSPOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1213 E 173RD ST APT 1, CLEVELAND, OH 44119-3168
(216) 250-5685
Mailing address
1213 E 173RD ST APT 1, CLEVELAND, OH 44119-3168
(216) 250-5685
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
10/17/2025
Last updated
10/17/2025
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