Provider Demographics
NPI:1194129148
Name:KLEVELAND, FAITH (CATCIII)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:KLEVELAND
Suffix:
Gender:F
Credentials:CATCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 E CANON PERDIDO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2242
Mailing Address - Country:US
Mailing Address - Phone:805-722-1312
Mailing Address - Fax:805-963-1720
Practice Address - Street 1:232 E CANON PERDIDO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2242
Practice Address - Country:US
Practice Address - Phone:805-722-1312
Practice Address - Fax:805-963-1720
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAADE 132799 III101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)