Provider Demographics
NPI:1235554825
Name:MEWHINNEY, JENNIFER (PCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MEWHINNEY
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6785 MIDDLEBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2651
Mailing Address - Country:US
Mailing Address - Phone:440-234-8746
Mailing Address - Fax:
Practice Address - Street 1:18660 BAGLEY RD
Practice Address - Street 2:MEDICAL ARTS BUILDING I, SUITE 404
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3483
Practice Address - Country:US
Practice Address - Phone:440-234-8746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1100285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2871101Medicaid