Lecretia Bolden
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Cleveland, OH
NPI 1124590633 · NPPES record last updated Dec 21, 2018
Key facts
- NPI
- 1124590633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 3622 Prospect Ave E
Cleveland, OH 44115-2704 - Phone
- (216) 431-4600
- NPI assigned
- Dec 21, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imex Inc | Addiction (Substance Use Disorder) | Past | Accepting new patients |
| Moore Counseling & Mediation Services, Inc. | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
3622 Prospect Ave E
Cleveland, OH 44115-2704
Mailing address
25151 Zeman Ave
Euclid, OH 44132-1806
Phone (216) 858-0724
Other providers in Cleveland, OH
- Delena Crystal Bolden
- Eric Bolden Jr.
- Jenoy M Bolden
- Lashana Bolden
- Lauren Denise Bolden
- Norman Bolden
- Katherine Claire Boldt
- Aparna Bole
- Raevti Bole
- Mikaela Bolek
All providers in Cleveland, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.