Jarvis T. Cleveland, LMSW
Individual provider Active NPI Counselor · Mountain BRK, AL
NPI 1356980049 · NPPES record last updated Dec 30, 2019
Key facts
- NPI
- 1356980049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 4887G (AL)
- Practice address
- 14 Office Park Cir Ste 102
Mountain BRK, AL 35223-2519 - Phone
- (205) 639-8081
- NPI assigned
- Dec 30, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4887G | AL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Write of Healing Counseling, LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4887G | AL | Yes |
Addresses
Primary practice location
14 Office Park Cir Ste 102
Mountain BRK, AL 35223-2519
Mailing address
14 Office Park Cir Ste 102
Mountain BRK, AL 35223-2519
Phone (205) 639-8081
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 832197896 | Medicaid | AL |
Other providers in Mountain BRK, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2019. 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.