Healthcare Provider Details

I. General information

NPI: 1700530862
Provider Name (Legal Business Name): SHARITA LINAE ASH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13377 SMITH RD
CLEVELAND OH
44130-7810
US

IV. Provider business mailing address

3521 LONGWOOD AVE
CLEVELAND OH
44115-3339
US

V. Phone/Fax

Practice location:
  • Phone: 440-340-5558
  • Fax:
Mailing address:
  • Phone: 216-882-8649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.183138
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: