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General NPI Number Information
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NPI Number | 1508753070
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Entity Type | Individual
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Provider Name | ROMEL CAIRO PRATHER
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Gender | Male
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1400 E 55TH ST
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City | CLEVELAND
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State | OH
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Zip | 44103-1304
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Country | US
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Telephone | 216-391-6672
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Fax | 216-391-4633
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Provider Business Mailing Address
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Address Line | 519 E 222ND ST
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City | EUCLID
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State | OH
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Zip | 44123-2029
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Country | US
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Telephone | 216-482-0019
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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Taxonomy #2
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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.194233
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License Number State | OH
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