Provider Demographics
NPI:1427558659
Name:MITCHELL, TALESHA M
Entity type:Individual
Prefix:
First Name:TALESHA
Middle Name:M
Last Name:MITCHELL
Suffix:
Gender:
Credentials:
Other - Prefix:MISS
Other - First Name:TALESHA
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:748 RADFORD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1940
Mailing Address - Country:US
Mailing Address - Phone:216-333-2237
Mailing Address - Fax:
Practice Address - Street 1:748 RADFORD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1940
Practice Address - Country:US
Practice Address - Phone:216-333-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2917642374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2917642Medicaid