Provider Demographics
NPI:1598569121
Name:NEVELS JR., EMMITT L JR
Entity type:Individual
Prefix:
First Name:EMMITT
Middle Name:L
Last Name:NEVELS JR.
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3168 MEANDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9629
Mailing Address - Country:US
Mailing Address - Phone:330-518-5384
Mailing Address - Fax:
Practice Address - Street 1:10613 LAMONTIER AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-4847
Practice Address - Country:US
Practice Address - Phone:330-518-5384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)