Healthcare Provider Details

I. General information

NPI: 1215706163
Provider Name (Legal Business Name): XIOMARA YOCHUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 S BROADWAY
LORAIN OH
44053-3821
US

IV. Provider business mailing address

6140 S BROADWAY
LORAIN OH
44053-3821
US

V. Phone/Fax

Practice location:
  • Phone: 440-233-7232
  • Fax: 440-282-4779
Mailing address:
  • Phone: 440-233-7232
  • Fax: 440-282-4779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2511854
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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: