Healthcare Provider Details

I. General information

NPI: 1043612088
Provider Name (Legal Business Name): ARIA NOVELLA NIMONS CASAC, LCDC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3607 CLINTON AVE APT 1
CLEVELAND OH
44113-2853
US

IV. Provider business mailing address

3607 CLINTON AVE APT 1
CLEVELAND OH
44113-2853
US

V. Phone/Fax

Practice location:
  • Phone: 216-780-8210
  • Fax: 216-780-8210
Mailing address:
  • Phone: 216-780-8210
  • Fax: 216-780-8210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number141033
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: