Healthcare Provider Details

I. General information

NPI: 1013661842
Provider Name (Legal Business Name): AMY S. HEUTMAKER MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date: 05/15/2025
Reactivation Date: 06/03/2025

III. Provider practice location address

2500 METROHEALTH DR
CLEVELAND OH
44109-1900
US

IV. Provider business mailing address

2500 METROHEALTH DR
CLEVELAND OH
44109-1900
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-4428
  • Fax:
Mailing address:
  • Phone: 216-778-4428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: