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NPI Code Detail

MEDICARE: CORNELL G ORR CDCA

MEDICARE: CORNELL G ORR 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.183556OH

General Provider Information

NPI Number : 1083193312
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORNELL G ORR CDCA
Provider Business Mailing Address
First Line : 1803 E 90TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2047
Country : US
Telephone Number : 216-804-4475
Fax Number :
Provider Business Practice Location Address
First Line : 9 CHESAPEAKE PLZ
Second Line :
City : CHESAPEAKE
State : OH
Zip : 45619-1003
Country : US
Telephone Number : 740-764-4529
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 03/10/2025

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