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Individual

LENA CLARICE MCGRAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CDCA

Contact information

Practice address
3364 W 91ST ST, CLEVELAND, OH 44102-4834
(216) 630-1608
Mailing address
3364 W 91ST ST, CLEVELAND, OH 44102-4834
(216) 630-1608

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
165991
OH
175T00000X
Peer Specialist
Primary
000673
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000673
OHIO CERTIFIED PEER RECOVERY SUPPORTER
OH
01
165991
OCDP
OH
Enumeration date
01/22/2019
Last updated
05/07/2021
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