Healthcare Provider Details

I. General information

NPI: 1902308091
Provider Name (Legal Business Name): MEI T. YEUNG JEFFERY LPCC, LCDCIII,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAY T. YEUNG JEFFERY LPCC, LCDCIII

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 W 25TH ST
CLEVELAND OH
44109-1951
US

IV. Provider business mailing address

2858 AARON DR
MEDINA OH
44256-7970
US

V. Phone/Fax

Practice location:
  • Phone: 216-865-1843
  • Fax:
Mailing address:
  • Phone: 216-316-3306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCIII.162234
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.164281
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1700606-TRNE
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2203089
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: