Healthcare Provider Details

I. General information

NPI: 1851242960
Provider Name (Legal Business Name): BRENDA A DANE MPH, MCHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SUPERIOR AVE STE 327
CLEVELAND OH
44114-2148
US

IV. Provider business mailing address

1900 SUPERIOR AVE STE 327
CLEVELAND OH
44114-2148
US

V. Phone/Fax

Practice location:
  • Phone: 347-234-5116
  • Fax: 440-970-1614
Mailing address:
  • Phone: 347-234-5116
  • Fax: 440-970-1614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: