Provider Demographics
NPI:1699265025
Name:MCCARGO, HARVETTA SIRBRINA
Entity type:Individual
Prefix:MS
First Name:HARVETTA
Middle Name:SIRBRINA
Last Name:MCCARGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3389 E 139TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3969
Mailing Address - Country:US
Mailing Address - Phone:216-799-9096
Mailing Address - Fax:
Practice Address - Street 1:3201 W 73RD ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-5212
Practice Address - Country:US
Practice Address - Phone:216-961-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$OtherSUBSTANCE ABUSE