Healthcare Provider Details

I. General information

NPI: 1720697154
Provider Name (Legal Business Name): JODI LYNNE CHUMITA BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JODI LYNNE SARVER

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 S TAYLOR RD
CLEVELAND HEIGHTS OH
44118-2161
US

IV. Provider business mailing address

1855 S TAYLOR RD
CLEVELAND HEIGHTS OH
44118-2161
US

V. Phone/Fax

Practice location:
  • Phone: 216-851-2221
  • Fax:
Mailing address:
  • Phone: 216-851-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-113331
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-24-15432
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: