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NPI Code Detail

MEDICARE: JASMINE ELISE ADDY

MEDICARE: JASMINE ELISE ADDY
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1720937139
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE ELISE ADDY
Provider Business Mailing Address
First Line : 2234 WARREN RD
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-5937
Country : US
Telephone Number : 216-427-2243
Fax Number :
Provider Business Practice Location Address
First Line : 4500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-3736
Country : US
Telephone Number : 216-432-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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Directions to “ JASMINE ELISE ADDY ” Practice Location

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