Provider Demographics
NPI:1285278283
Name:JONESPRICE, LAVETTA LOUISE (CDCA, AA ,)
Entity type:Individual
Prefix:
First Name:LAVETTA
Middle Name:LOUISE
Last Name:JONESPRICE
Suffix:
Gender:F
Credentials:CDCA, AA ,
Other - Prefix:
Other - First Name:LAVETTA
Other - Middle Name:LOUISE
Other - Last Name:JONESPRICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDCA , AA
Mailing Address - Street 1:11412 COTES AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6241
Mailing Address - Country:US
Mailing Address - Phone:216-800-2623
Mailing Address - Fax:
Practice Address - Street 1:3830 E 131ST ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4664
Practice Address - Country:US
Practice Address - Phone:216-800-2623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-01
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.166190101YA0400X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)