Healthcare Provider Details

I. General information

NPI: 1821928383
Provider Name (Legal Business Name): FORTITUDE WELLNESS AND CONSULTATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 ROCKSIDE RD UNIT 25611
GARFIELD HEIGHTS OH
44125-7331
US

IV. Provider business mailing address

12401 ROCKSIDE RD UNIT 25611
GARFIELD HEIGHTS OH
44125-7331
US

V. Phone/Fax

Practice location:
  • Phone: 216-303-4196
  • Fax:
Mailing address:
  • Phone: 216-303-4196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BRYANTA L SPENCER
Title or Position: CEO/CLINICAL DIRECTOR
Credential: LISW-S
Phone: 216-303-4196