Healthcare Provider Details

I. General information

NPI: 1326578543
Provider Name (Legal Business Name): JENNIFER LYNN CHIARELLO CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 10/25/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 NESMITH LAKE BLVD
AKRON OH
44314-3427
US

IV. Provider business mailing address

838 COBURN ST
AKRON OH
44311-1459
US

V. Phone/Fax

Practice location:
  • Phone: 330-858-7375
  • Fax:
Mailing address:
  • Phone: 330-812-3129
  • Fax: 330-208-2136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number140576
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: