Healthcare Provider Details

I. General information

NPI: 1487562039
Provider Name (Legal Business Name): ANGELA ROMINE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

14445 BROADWAY AVE
CLEVELAND OH
44125-1957
US

IV. Provider business mailing address

7201 LAWN AVE
CLEVELAND OH
44102-4117
US

V. Phone/Fax

Practice location:
  • Phone: 216-677-8177
  • Fax:
Mailing address:
  • Phone: 216-296-2307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.196388
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: