LORETTA WILSON CDCA, PEER SUPPORT NPI 1003421819

Peer Specialist in Cleveland, OH

NPI 1003421819 Individual Female Peer Specialist

About LORETTA WILSON

Loretta Wilson is a provider established in Cleveland, Ohio and her medical specialization is peer specialist. The NPI number of Loretta Wilson is 1003421819 and was assigned on September 2020. The practitioner's primary taxonomy code is 175T00000X with license number 1005 (OH). The provider is registered as an individual and her NPI record was last updated one year ago.

Loretta Wilson is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.

NPI

1003421819

Provider Name LORETTA WILSON CDCA, PEER SUPPORT
Provider Location Address3018 E 128TH ST CLEVELAND, OH 44120
Provider Mailing Address3018 E 128TH ST CLEVELAND, OH 44120
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date09-09-2020
Last Update Date09-09-2020


Primary Taxonomy

Taxonomy Code175T00000X
ClassificationPeer Specialist
TypeOther Service Providers
License No.1005
License StateOH
Taxonomy DescriptionIndividuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Business Address

LORETTA WILSON CDCA, PEER SUPPORT
3018 E 128TH ST
CLEVELAND, OH
ZIP 44120
Phone: (216) 256-8500

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Mailing Address

LORETTA WILSON CDCA, PEER SUPPORT
3018 E 128TH ST
CLEVELAND, OH
ZIP 44120
Phone: (216) 256-8500



NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.