Healthcare Provider Details

I. General information

NPI: 1366236200
Provider Name (Legal Business Name): UNITED STATES TELEPATHY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2867 MAYFIELD RD APT 1
CLEVELAND HEIGHTS OH
44118-2050
US

IV. Provider business mailing address

2867 MAYFIELD RD APT 1
CLEVELAND HEIGHTS OH
44118-2050
US

V. Phone/Fax

Practice location:
  • Phone: 216-314-7571
  • Fax:
Mailing address:
  • Phone: 216-314-7571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code344800000X
TaxonomyAir Carrier
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: PROF. XAVIER DIRELL WILLIS
Title or Position: XAVIER6
Credential:
Phone: 216-314-7571