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NPI Code Detail

MEDICARE: SHAWANNA BAKER CDCA

MEDICARE: SHAWANNA BAKER CDCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.170465OH

General Provider Information

NPI Number : 1083106371
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWANNA BAKER CDCA
Provider Business Mailing Address
First Line : 560 WALNUT DR
Second Line :
City : EUCLID
State : OH
Zip : 44132-2116
Country : US
Telephone Number : 216-800-3561
Fax Number :
Provider Business Practice Location Address
First Line : 1227 ANSEL RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44108-3323
Country : US
Telephone Number : 216-421-0662
Fax Number : 844-593-7239
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2018
Last Update Date : 11/14/2024

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Directions to “ SHAWANNA BAKER CDCA” Practice Location

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