MEDICARE: MRS. CHEYENNE M PARIS 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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCAPRE.195169	OH

General Provider Information

NPI Number	:	1558218552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHEYENNE M PARIS CDCA

Provider Business Mailing Address
First Line	:	725 BOARDMAN CANFIELD RD STE C4
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-4367
Country	:	US
Telephone Number	:	855-292-9778
Fax Number	:	855-292-9778

Provider Business Practice Location Address
First Line	:	430 WILLIAMSON AVE
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44507-1226
Country	:	US
Telephone Number	:	855-292-9778
Fax Number	:	855-292-9778

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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