Healthcare Provider Details

I. General information

NPI: 1396672648
Provider Name (Legal Business Name): KATHERINE CLAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6516 DETROIT AVE
CLEVELAND OH
44102-3057
US

IV. Provider business mailing address

2104 W 10TH ST APT 3
CLEVELAND OH
44113-3648
US

V. Phone/Fax

Practice location:
  • Phone: 216-372-7587
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2507277
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: