MEDICARE: UNITED LABOR AGENCY

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
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1265204051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED LABOR AGENCY

Provider Business Mailing Address
First Line	:	737 BOLIVAR RD STE 300
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1246
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	737 BOLIVAR RD STE 300
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1246
Country	:	US
Telephone Number	:	216-664-3446
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	ALICIA BOREMAN
Credential	:
Telephone Number	:	419-819-8428

Provider Enumeration Date	:	10/25/2023
Last Update Date	:	10/25/2023

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Directions to “UNITED LABOR AGENCY ” Practice Location

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