MS. SONIA THERESE PROVARD (NPI# 1235761586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235761586 |
| Entity Type | Individual |
| Full Name | MS. SONIA THERESE PROVARD |
| Other Name | MRS. SONIA T KRUSINSKI |
| Credential | CERTIFIED PEER RECOV |
| Practice Address |
3500 Carnegie Ave Cleveland OH 44115-2641 |
| Mailing Address |
202 E Bagley Rd Berea OH 44017-2058 |
| Practice Telephone | 2162608300 |
| Mailing Telephone | 4402606408 |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | OH | Other Service Providers |
| Street Address |
3500 CARNEGIE AVE |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44115-2641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386622934 | Kevin James Williamson | Counselor | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2006-01-04 |
| 1720689573 | Johnna Miska | Community Health Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-11-06 |
| 1962003723 | Lori Musarra | Community Health Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-11-06 |
| 1861093700 | Leah Popkin | Community Health Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-11-06 |
| 1700486487 | Gina M Branco | Counselor | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-10-30 |
| 1770183659 | Hannah B Vertal | Community Health Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-10-29 |
| 1417556432 | Derrick A Pledger | Counselor | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-10-21 |
| 1255930285 | Jessica Raye Yeager | Community Health Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-10-21 |
| 1588263859 | Kaeley Doyle | Counselor | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-10-19 |
| 1225636822 | Erica J. Tapia-mateo | Community Health Worker | 3500 Carnegie Ave, Cleveland, OH 44115-2641 | 2020-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117299 | Ann Marie Louise Melinz | Counselor | 2525 West 22nd Street, Cleveland, OH 44115 | 2020-09-03 |
| 1881231850 | Steven Kelly | Case Management | 3500 Carnegie Ave., Cleveland, OH 44115 | 2019-12-09 |
| 1649821422 | Larry Hollimon | Technician | 2320 East 30th Street, Apt #1304, Cleveland, OH 44115 | 2019-09-24 |
| 1306332408 | Tyler Milam | Counselor | 2334 Prospect Ave., 400, Cleveland, OH 44115 | 2018-07-02 |
| 1780108019 | Victoria Charles | Registered Nurse | 2500 E. 22nd St, Cleveland, OH 44115 | 2017-07-28 |
| 1528580511 | Randol Jamel Kennedy | Internal Medicine | 2351 East 22nd Street Suite 338 W, St. Vincent Charity Medical Center, Cleveland, OH 44115 | 2017-07-11 |
| 1508393422 | Gang Anthony Lu | Dentist | 1110 Euclid Ave Ste 202, Cleveland, OH 44115 | 2017-05-23 |
| 1093116501 | Megan Shiles | Psychologist | 2675 East 30th St., Cleveland, OH 44115 | 2014-09-16 |
| 1003224577 | Efewongbe Benedicta Oleghe | Internal Medicine | 2351 E 22nd Street, St Vincent's Charity Medical Center, Cleveland, OH 44115 | 2014-07-29 |
| 1982032074 | Andrew Winchester | Social Worker | 2500 Carnegie Ave, Cleveland, OH 44115 | 2013-10-29 |
| Find all providers in zip 44115 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals 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. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345989 | Kyle Johnston | Peer Specialist | 10525 Clifton Blvd Apt 3, Cleveland, OH 44102-1586 | 2020-11-01 |
| 1972101012 | Cindy Ann Kozlik | Peer Specialist | 600 W.superior Ave, Cleveland, OH 44113 | 2020-10-12 |
| 1053918565 | Tina Louise Neal | Peer Specialist | 3637 Green Rd, Cleveland, OH 44122-5779 | 2020-10-07 |
| 1326645805 | Kristen Krajewski | Peer Specialist | 3105 Woodbridge Ave, Cleveland, OH 44109-2175 | 2020-10-07 |
| 1538774153 | Sarah Louise Woodside | Peer Specialist | 4478 S Hills Dr, Cleveland, OH 44109-4479 | 2020-09-10 |
| 1003421819 | Loretta Wilson | Peer Specialist | 3018 E 128th St, Cleveland, OH 44120-3003 | 2020-09-09 |
| 1558975128 | Jessica Ann Bair | Peer Specialist | 4606 Gifford Ave, Cleveland, OH 44144-2944 | 2020-09-01 |
| 1407460280 | Shiyla Ann Nix | Peer Specialist | 2230 E 82nd St, Cleveland, OH 44103-5008 | 2020-08-31 |
| 1538772611 | Ross Hilaszek | Peer Specialist | 2001 Willowdale Ave, Cleveland, OH 44109-2838 | 2020-08-28 |
| 1760008254 | Sober First, LLC | Peer Specialist | 4415 Euclid Ave Ste 204, Cleveland, OH 44103-3758 | 2020-06-19 |
| Find all providers in CLEVELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.