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NPI Code Detail

MEDICARE: MISS KATHRYN YOLANDA PARKS

MEDICARE: MISS KATHRYN YOLANDA PARKS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101Y00000XCounselorC.2305684OH

General Provider Information

NPI Number : 1942868922
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KATHRYN YOLANDA PARKS
Provider Business Mailing Address
First Line : 30950 SUMMIT LN
Second Line :
City : PEPPER PIKE
State : OH
Zip : 44124-5843
Country : US
Telephone Number : 216-536-3004
Fax Number :
Provider Business Practice Location Address
First Line : 2020 CARNEGIE AVE # UP
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2337
Country : US
Telephone Number : 216-260-1366
Fax Number : 216-674-6300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2019
Last Update Date : 01/12/2024

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Directions to “ MISS KATHRYN YOLANDA PARKS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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