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General NPI Number Information
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NPI Number | 1326677402
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Entity Type | Individual
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Provider Name | KAREN FLORENCE C-CHW
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Gender | Female
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 12200 FAIRHILL ROAD C-349
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City | CLEVELAND
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State | OH
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Zip | 44120
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Country | US
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Telephone | 216-336-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 12200 FAIRHILL ROAD C-349
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City | CLEVELAND
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State | OH
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Zip | 44120
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Country | US
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Telephone | 216-336-5001
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.172457
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 001182
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | APS.001129
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License Number State | OH
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