Connietoretta Al-Shami, OCPRS
Counselor, Addiction (Substance Use Disorder) in Beachwood, OH. Individual provider (NPI-1).
NPI number1699355966
StatusActive
Last updated in NPPESMay 7, 2025
Details
- NPI
- 1699355966
- Entity type
- Individual (NPI-1)
- Name
- Connietoretta Al-Shami
- Credential
- OCPRS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 12, 2021
- Certification date
- May 7, 2025
- Last updated
- May 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
| 175T00000X | Peer Specialist | 0002339 | OH | |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
25201 Chagrin BlvdBeachwood, OH 44122-5600
Phone 216-910-9015 · Fax 216-910-9015
Mailing address
3214 Prospect Ave ECleveland, OH 44115-2614
Phone 216-910-9015
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