Provider Demographics
NPI:1346079423
Name:FRIERSON, CHEVE
Entity type:Individual
Prefix:
First Name:CHEVE
Middle Name:
Last Name:FRIERSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15503 EDGEWOOD AVE # 204
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-3907
Mailing Address - Country:US
Mailing Address - Phone:216-209-8799
Mailing Address - Fax:
Practice Address - Street 1:815 SUPERIOR AVE E STE 1618
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2709
Practice Address - Country:US
Practice Address - Phone:216-209-8799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X, 251F00000X, 320800000X, 376J00000X
320900000X
OH186919164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No376J00000XNursing Service Related ProvidersHomemaker