Provider Demographics
NPI:1942714936
Name:TADESE, ABDUSEMIH (MUS,QMHS)
Entity Type:Individual
Prefix:MR
First Name:ABDUSEMIH
Middle Name:
Last Name:TADESE
Suffix:
Gender:M
Credentials:MUS,QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 E 45TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44127-1093
Mailing Address - Country:US
Mailing Address - Phone:440-508-2006
Mailing Address - Fax:
Practice Address - Street 1:3100 E 45TH ST STE 212
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1093
Practice Address - Country:US
Practice Address - Phone:440-508-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health