Provider Demographics
NPI:1871733246
Name:CLEVERING, DANA DIANNE (MS, LMHC, EMDR)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:DIANNE
Last Name:CLEVERING
Suffix:
Gender:F
Credentials:MS, LMHC, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 S SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46814-9702
Mailing Address - Country:US
Mailing Address - Phone:260-358-7180
Mailing Address - Fax:
Practice Address - Street 1:412 S SCOTT RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814-9702
Practice Address - Country:US
Practice Address - Phone:260-358-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002359A101YP2500X
TX17740101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional