Provider Demographics
NPI:1366236200
Name:UNITED STATES TELEPATHY
Entity type:Organization
Organization Name:UNITED STATES TELEPATHY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:XAVIER6
Authorized Official - Prefix:PROF
Authorized Official - First Name:XAVIER
Authorized Official - Middle Name:DIRELL
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-314-7571
Mailing Address - Street 1:2867 MAYFIELD RD APT 1
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2050
Mailing Address - Country:US
Mailing Address - Phone:216-314-7571
Mailing Address - Fax:
Practice Address - Street 1:2867 MAYFIELD RD APT 1
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2050
Practice Address - Country:US
Practice Address - Phone:216-314-7571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No305S00000XManaged Care OrganizationsPoint of Service
No344800000XTransportation ServicesAir Carrier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3K90-WR2-CX26Medicaid