Healthcare Provider Details

I. General information

NPI: 1013706068
Provider Name (Legal Business Name): DICEN BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 YORK RD STE 207
PARMA HEIGHTS OH
44130-3030
US

IV. Provider business mailing address

6325 YORK RD STE 207
PARMA HEIGHTS OH
44130-3030
US

V. Phone/Fax

Practice location:
  • Phone: 216-219-8257
  • Fax:
Mailing address:
  • Phone: 440-834-2400
  • Fax: 440-834-2400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN A NKENGLEFAC
Title or Position: PMHNP-BC
Credential: CNP
Phone: 440-834-2400