Individual
EARL MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMS-HS
Contact information
Practice address
1302 WINSLOW AVE, CLEVELAND, OH 44113-2336
(216) 727-2086
Mailing address
1320 WASHINGTON AVE, CLEVELAND, OH 44113-2333
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111111
CMS-HS
OH
Enumeration date
05/21/2018
Last updated
10/29/2021
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