JACQUELINE VERNADE WILLIS (NPI# 1477938223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477938223 |
| Entity Type | Individual |
| Full Name | JACQUELINE VERNADE WILLIS |
| Credential | LCDC II |
| Practice Address |
3135 Euclid Ave Cleveland OH 44115-2531 |
| Practice Telephone | 2163912064 |
| Practice Fax Number | 2164317189 |
| Mailing Telephone | 2163912064 |
| Mailing Fax Number | 2164317189 |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 141253 | OH | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356819858 | Jacqueline Willis | Case Manager/Care Coordinator | 137 Willett Rd, Arcadia, LA 71001-5624 | 2018-11-02 |
| 1073908281 | Jacqueline Eva Willis | Nurse Practitioner | 4101 Barbara Loop Se, Suite D, Rio Rancho, NM 87124-1009 | 2015-04-03 |
| Street Address |
3135 EUCLID AVE |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44115-2531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659328771 | Catholic Charities Corporation | Clinic/Center | 3135 Euclid Ave, Suite 202, Cleveland, OH 44115-2531 | 2006-05-27 |
| 1356835706 | Karl Winfrey | Counselor | 3135 Euclid Ave, Cleveland, OH 44115-2531 | 2018-06-19 |
| 1700377678 | Mouyad Abduljabar | Counselor | 3135 Euclid Ave, Cleveland, OH 44115-2531 | 2018-05-25 |
| 1386134120 | Lashana Bolden | Case Manager/Care Coordinator | 3135 Euclid Ave, Cleveland, OH 44115-2531 | 2018-05-17 |
| 1689163958 | Donnell Decarlo Dunaway | Counselor | 3135 Euclid Ave, Cleveland, OH 44115-2531 | 2018-05-02 |
| 1417493669 | Tomeka Rosha Ewing | Counselor | 3135 Euclid Ave, Suite 202, Cleveland, OH 44115 | 2017-01-12 |
| 1861946501 | Brian Freeman | Counselor | 3135 Euclid Ave, Suite 202, Cleveland, OH 44115-2531 | 2016-08-11 |
| 1023476900 | Thomas Gates | Counselor | 3135 Euclid Ave, Cleveland, OH 44115-2531 | 2016-02-05 |
| 1063897619 | Mark H Price | Counselor | 3135 Euclid Ave, Cleveland, OH 44115-2531 | 2015-07-24 |
| 1659756278 | Gregory Johnson | Counselor | 3135 Euclid Ave, Cleveland, OH 44115-2531 | 2015-07-24 |
| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654740 | Justin's Love Home Health Agency | Community/Behavioral Health | 17325 Euclid Ave Ste 2017, Cleveland, OH 44112-1250 | 2020-09-21 |
| 1063024008 | To Attain Healing LLC | Community/Behavioral Health | 17325 Euclid Ave Ste 3060, Cleveland, OH 44112-1256 | 2020-08-20 |
| 1740806751 | One Child Every Chance Foundation LLC | Community/Behavioral Health | 5909 Cable Ave, Cleveland, OH 44127-1745 | 2020-06-25 |
| 1649899048 | Amyra Support Services, LLC | Community/Behavioral Health | 11811 Shaker Blvd Ste 113d, Cleveland, OH 44120-1927 | 2020-04-15 |
| 1447886973 | Infinity Hearts LLC | Community/Behavioral Health | 17325 Euclid Ave Ste 4133, Cleveland, OH 44112-1262 | 2020-03-16 |
| 1184255549 | Peter James Development & Independent Living, Inc. | Community/Behavioral Health | 17325 Euclid Ave Ste 4103, Cleveland, OH 44112-1262 | 2020-02-03 |
| 1255970679 | Heart To Heart Health and Wellness | Community/Behavioral Health | 17325 Euclid Ave Ste 2145, Cleveland, OH 44112-1247 | 2020-01-02 |
| 1164068540 | First and Twenty Five LLC | Community/Behavioral Health | 12305 Arlington Ave, Cleveland, OH 44108-2359 | 2019-11-21 |
| 1124580303 | Lighthouse Community Care Inc | Community/Behavioral Health | 4500 Lee Rd Ste 231, Cleveland, OH 44128-2959 | 2019-04-04 |
| 1467916809 | Inter-cept Consultant Services, LLC | Community/Behavioral Health | 13303 Beachwood Ave, Cleveland, OH 44105-6415 | 2019-01-30 |
| 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.