Healthcare Provider Details

I. General information

NPI: 1639598428
Provider Name (Legal Business Name): CYNNAIRIA CAVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 FAIRMOUNT BLVD STE C
CLEVELAND OH
44106-3177
US

IV. Provider business mailing address

2180 JACKSON BLVD
CLEVELAND HEIGHTS OH
44118-3009
US

V. Phone/Fax

Practice location:
  • Phone: 216-347-8866
  • Fax:
Mailing address:
  • Phone: 216-347-8866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1957161
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number3629224
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: