MEDICARE: CAMRYN MARIE KADEL

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	LCDCIII.162986	OH

General Provider Information

NPI Number	:	1588486450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMRYN MARIE KADEL

Provider Business Mailing Address
First Line	:	23611 CHAGRIN BLVD STE 103
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5540
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16101 EUCLID BEACH BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-1175
Country	:	US
Telephone Number	:	216-486-2300
Fax Number	:

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

Provider Enumeration Date	:	10/30/2024
Last Update Date	:	03/31/2026

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