Individual
SHAVON J KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
927 E 218TH ST, EUCLID, OH 44119-2423
(216) 345-9056
Mailing address
927 E 218TH ST, EUCLID, OH 44119-2423
(216) 345-9056
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251B00000X
Case Management Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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