Healthcare Provider Details

I. General information

NPI: 1558196261
Provider Name (Legal Business Name): SUPPORTIVE ADVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 LEE BLVD STE 215
CLEVELAND HEIGHTS OH
44118-1269
US

IV. Provider business mailing address

2490 LEE BLVD STE 215
CLEVELAND HEIGHTS OH
44118-1269
US

V. Phone/Fax

Practice location:
  • Phone: 440-423-5955
  • Fax:
Mailing address:
  • Phone: 440-423-5955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AQUEELAH WHEATLEY
Title or Position: THERAPIST
Credential: IMFT
Phone: 440-423-5955