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General NPI Number Information
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NPI Number | 1376481440
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Entity Type | Individual
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Provider Name | DETELIN WILLIAM CASHMAN CDCA
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Gender | Male
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 155 MONTROSE WEST AVE
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City | COPLEY
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State | OH
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Zip | 44321-3121
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Country | US
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Telephone | 330-993-4946
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 MANITOULIN PIKE
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City | BRUNSWICK
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State | OH
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Zip | 44212-2824
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Country | US
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Telephone | 216-390-5427
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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 | CDCA193856
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License Number State | OH
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