MEDICARE: DIGNIFIED COUNSELING CLEVELAND LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1487373411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGNIFIED COUNSELING CLEVELAND LLC

Provider Business Mailing Address
First Line	:	4405 SILSBY RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3938
Country	:	US
Telephone Number	:	201-741-0232
Fax Number	:

Provider Business Practice Location Address
First Line	:	4405 SILSBY RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3938
Country	:	US
Telephone Number	:	201-741-0232
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. YAEL VINEBURG
Credential	:	LPCC
Telephone Number	:	201-741-0232

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	08/23/2022

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