Dual Diagnosis Center of Greater Cleveland Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

12259, 575 Issued in OH

Legal business name

DUAL DIAGNOSIS CENTER OF GREATER CLEVELAND INC

Practice address

2012 W 25TH St Ste 411
Cleveland, OH 44113-4131

Phone

(216) 623-3555

Fax

(216) 623-3555

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Barbara O Beres, LICDC, LPC

Title

President

Phone

(216) 623-3555

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073571360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4486 SILSBY RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441183939",
            "telephone_number": "216-623-3555",
            "fax_number": "216-623-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 W 25TH ST STE 411",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441134131",
            "telephone_number": "216-623-3555",
            "fax_number": "216-623-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUAL DIAGNOSIS CENTER OF GREATER CLEVELAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERES",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-623-3555",
        "authorized_official_credential": "LICDC, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "12259, 575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MACSIS",
            "identifier": "12259",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.