MEDICARE: ABEL ODOYO ORIRI LPCC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	E-0001669	OH
2	106H00000X	Marriage & Family Therapist	E-0001669	OH
3	101YP1600X	Pastoral Counselor	E-0001669	OH
4	101YP2500X	Professional Counselor	E-0001669	OH
5	101Y00000X	Counselor	E-0001669	OH
6	101YM0800X	Mental Health Counselor	E-0001669	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	226098000	OTHER	OH	MAGELLAN
2	246638	OTHER	OH	VALUE OPTION
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	294948799	OTHER	OH	CARE SOURCE
5	53143805	OTHER		UBH

General Provider Information

NPI Number	:	1205059433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABEL ODOYO ORIRI LPCC

Provider Business Mailing Address
First Line	:	3846 BAINBRIDGE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2246
Country	:	US
Telephone Number	:	216-371-3405
Fax Number	:	216-371-4597

Provider Business Practice Location Address
First Line	:	1991 LEE RD
Second Line	:	SUITE 10
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-2571
Country	:	US
Telephone Number	:	216-371-4505
Fax Number	:	216-371-4597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	09/13/2016

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