Provider Demographics
NPI:1639598428
Name:CAVER, CYNNAIRIA
Entity Type:Individual
Prefix:
First Name:CYNNAIRIA
Middle Name:
Last Name:CAVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 JACKSON BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3009
Mailing Address - Country:US
Mailing Address - Phone:216-347-8866
Mailing Address - Fax:
Practice Address - Street 1:2460 FAIRMOUNT BLVD STE C
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-3177
Practice Address - Country:US
Practice Address - Phone:216-347-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 172V00000X, 175T00000X
OH1957161332B00000X
OH3629224171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies