Organization Active NPI

Iscream Social LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Euclid, OH
National Provider Identifier
1043011505
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ISCREAM SOCIAL LLC
Practice address
928 Glenside Rd
South Euclid, OH 44121-3442
Phone
(330) 348-4524
NPI assigned
Mar 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dornice Ivanna FridayNPI 1053941195
Title
Owner/Ceo
Phone
(330) 348-4524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

928 Glenside Rd
South Euclid, OH 44121-3442

Mailing address

928 Glenside Rd
South Euclid, OH 44121-3442
Phone (330) 348-4524

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1043011505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 GLENSIDE RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213442",
            "telephone_number": "330-348-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 GLENSIDE RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213442",
            "telephone_number": "330-348-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISCREAM SOCIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "FRIDAY",
        "authorized_official_first_name": "DORNICE",
        "authorized_official_middle_name": "IVANNA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "330-348-4524"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.