# CLEMENTINE PSYCHIATRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285590117
- **Authorized official:** NICOLE NEALE (OWNER)
- **Authorized official phone:** (216) 208-5884

## Contact information

- **Practice address:** 27700 FAIRMOUNT BLVD, CLEVELAND, OH 44124-4612
- **Practice address phone:** (216) 208-5884
- **Practice address fax:** (216) 250-9611
- **Mailing address:** 27700 FAIRMOUNT BLVD, CLEVELAND, OH 44124-4612
- **Mailing address phone:** (216) 208-5884
- **Mailing address fax:** (216) 250-9611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2026
- **Last updated:** 01/05/2026