Healthcare Provider Details

I. General information

NPI: 1437083565
Provider Name (Legal Business Name): AMY DINGESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E 55TH ST
CLEVELAND OH
44103-1304
US

IV. Provider business mailing address

3202 RUBY AVE DOWN
CLEVELAND OH
44109-4356
US

V. Phone/Fax

Practice location:
  • Phone: 216-391-6672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number196387
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: