Healthcare Provider Details

I. General information

NPI: 1437904687
Provider Name (Legal Business Name): BREAKING ALL BARRIERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3558 E 142ND ST APT 1
CLEVELAND OH
44120-5805
US

IV. Provider business mailing address

3558 E 142ND ST APT 1
CLEVELAND OH
44120-5805
US

V. Phone/Fax

Practice location:
  • Phone: 216-905-3080
  • Fax:
Mailing address:
  • Phone: 216-336-6261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: TAWANNA TYSON
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, SWA
Phone: 216-336-6261