Healthcare Provider Details

I. General information

NPI: 1881248862
Provider Name (Legal Business Name): WHITNEY CABRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 10/08/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 MOUNT VERNON AVE STE 1233
COLUMBUS OH
43203-1578
US

IV. Provider business mailing address

1245 MOUNT VERNON AVE STE 1233
COLUMBUS OH
43203-1578
US

V. Phone/Fax

Practice location:
  • Phone: 216-400-0207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number477875
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: