Provider Demographics
NPI:1376314062
Name:STEVENSON, SYREETA MARIE
Entity type:Individual
Prefix:
First Name:SYREETA
Middle Name:MARIE
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SYREETA
Other - Middle Name:MARIE
Other - Last Name:MCMILLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3462 NORTHCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3608
Mailing Address - Country:US
Mailing Address - Phone:216-538-8460
Mailing Address - Fax:
Practice Address - Street 1:23660 MILES RD STE 100
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5461
Practice Address - Country:US
Practice Address - Phone:216-312-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator