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NPI Code Detail

MEDICARE: OHIO SUBSTANCE ABUSE PROFESSIONALS LLC

MEDICARE: OHIO SUBSTANCE ABUSE PROFESSIONALS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101Y00000XCounselor
3101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811850498
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO SUBSTANCE ABUSE PROFESSIONALS LLC
Provider Business Mailing Address
First Line : 7801 DAY DR UNIT 29054
Second Line :
City : CLEVELAND
State : OH
Zip : 44129-5656
Country : US
Telephone Number : 216-232-9538
Fax Number : 216-270-7347
Provider Business Practice Location Address
First Line : 7801 DAY DR UNIT 29054
Second Line :
City : CLEVELAND
State : OH
Zip : 44129-5656
Country : US
Telephone Number : 216-323-9538
Fax Number : 216-270-7347
Authorized Official
Title or Position : OWNER
Name : JASON SOPKOVICH
Credential : LICDC LPC
Telephone Number : 216-232-9538
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “OHIO SUBSTANCE ABUSE PROFESSIONALS LLC ” Practice Location

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