White, Travaughn Dominic

White, Travaughn Dominic is an sole proprietor health care provider with primary practice located at 3500 Carnegie Ave , Cleveland OH 44115-2641. He recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Agencies / Case Management. Agencies / Community/Behavioral Health is his primary health care specialty. White, Travaughn Dominic can be contacted via phone (216) 372-3523.

Contact Information

Primary practice address
3500 Carnegie Ave Cleveland OH 44115-2641
Phone: (216) 372-3523
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X Ohio
Agencies / Case Management 251B00000X Ohio

Profile Details

NPI number 1346887247
LBN Legal business name White, Travaughn Dominic
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 10th, 2019
Last updated Dec 27th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346887247 NPPES
Ohio MEDICAID VB326494

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