Healthcare Provider Details

I. General information

NPI: 1821945510
Provider Name (Legal Business Name): JENNIFER CABRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 CLARKINS DR
YOUNGSTOWN OH
44515-1120
US

IV. Provider business mailing address

455 8TH ST APT 1
STRUTHERS OH
44471-1072
US

V. Phone/Fax

Practice location:
  • Phone: 380-228-2587
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number192447
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number005825
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: