MEDICARE: AMEENA MARIE IGRAM LPC

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	101YP2500X	Professional Counselor	C.2608061	OH

General Provider Information

NPI Number	:	1861321747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMEENA MARIE IGRAM LPC

Provider Business Mailing Address
First Line	:	3300 MONROE AVE UNIT FRONT
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3994
Country	:	US
Telephone Number	:	440-454-3840
Fax Number	:

Provider Business Practice Location Address
First Line	:	4983 RIDGE RD
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-9738
Country	:	US
Telephone Number	:	419-681-4241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2026
Last Update Date	:	05/16/2026

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Directions to “ AMEENA MARIE IGRAM LPC” Practice Location

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