Provider Demographics
NPI:1659902856
Name:CLEVELAND, MORIAH (LPC)
Entity Type:Individual
Prefix:
First Name:MORIAH
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 EUCLID AVE APT 721
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2423
Mailing Address - Country:US
Mailing Address - Phone:919-748-8569
Mailing Address - Fax:
Practice Address - Street 1:37303 HARVEST AVE
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-2803
Practice Address - Country:US
Practice Address - Phone:919-748-8569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHC.1800926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker