ETHAN RADATZ (NPI# 1316591019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316591019 |
| Entity Type | Individual |
| Full Name | ETHAN RADATZ |
| Practice Address |
6140 S Broadway Lorain OH 44053-3821 |
| Mailing Address |
292 Benedict Ave Norwalk OH 44857-2374 |
| Practice Telephone | 4402337232 |
| Practice Fax Number | 4402044315 |
| Mailing Telephone | 4196633737 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-01-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CDCA.170469 | OH | Behavioral Health & Social Service Providers |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
6140 S BROADWAY |
| City | LORAIN |
| State | OH |
| Zip Code | 44053-3821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497751796 | Manuel Enrique Gordillo Sr. | Specialist | 6140 S Broadway, Lorain, OH 44053-3891 | 2005-06-22 |
| 1447858964 | Raymone Letroy Wells Jr. | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3821 | 2020-10-16 |
| 1932707734 | Rachel Elizabeth Porrello | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-10-14 |
| 1336756634 | Laura Lynn Weppler | Registered Nurse | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-09-30 |
| 1902412307 | Janelle Kinney | Social Worker | 6140 S Broadway, Lorain, OH 44053-3821 | 2020-09-21 |
| 1699381004 | Melanie Anne Glavic | Counselor | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-09-21 |
| 1619583101 | Momoko H Barton | Social Worker | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-09-20 |
| 1245845551 | Alexis Feronti | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-09-14 |
| 1659986537 | Glen Allan Morse | Licensed Practical Nurse | 6140 S Broadway, Lorain, OH 44053-3821 | 2020-09-09 |
| 1346854569 | Kathryn Ann Carico | Registered Nurse | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242196 | Yokita Maria Thomas | Homemaker | 4818 Ashland Ave, Lordin, OH 44053 | 2020-10-14 |
| 1497353445 | Matthew George Simkovich | Homemaker | 4366 Jenee Dr, Lorain, OH 44053 | 2020-10-13 |
| 1881229979 | Christine Wilson | Physical Therapist | 5940 Oak Point Rd., Lorain, Lorain, OH 44053 | 2020-03-09 |
| 1912538760 | Barry Delaney Masin | Student in an Organized Health Care Education/Training Program | 2704 West Erie Avenue, Lorain, OH 44053 | 2020-01-30 |
| 1275171399 | Martina Beato | Social Worker | The Nord Center 6140 S. Broadway, Lorain, OH 44053 | 2019-12-19 |
| 1285279802 | Tivan LLC | Non-emergency Medical Transport (VAN) | 5821 Williamsburg Dr., Lorain, OH 44053 | 2019-11-07 |
| 1023650843 | Candace Taber | Case Manager/Care Coordinator | 6140 South Broadway, Lorain, OH 44053 | 2019-10-14 |
| 1265956098 | Phillip H Emerson | Social Worker | 1740 Cooper Foster Park Road East, Lorain, OH 44053 | 2017-08-02 |
| 1447796750 | Kafilat Idowu Kelani | Nurse Practitioner | 3700 Kolbe Rd, Lorain, Lorain, OH 44053 | 2017-01-10 |
| 1083075808 | Mark B Applegate | Counselor | 2115 West Park Drive, Lorain, OH 44053 | 2016-03-08 |
| Find all providers in zip 44053 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023650843 | Candace Taber | Case Manager/Care Coordinator | 6140 South Broadway, Lorain, OH 44053 | 2019-10-14 |
| 1235609421 | Tiana Denae Mitchell | Case Manager/Care Coordinator | 420 E 43rd St, Lorain, OH 44052-5476 | 2018-11-29 |
| 1063982643 | Jasmine Harris | Case Manager/Care Coordinator | 6410 S Broadway, Lorain, OH 44105 | 2018-11-27 |
| 1649761099 | Lakya S Hunter | Case Manager/Care Coordinator | 1865 N Ridge Rd E Ste C, Lorain, OH 44055-3359 | 2018-05-22 |
| 1447858964 | Raymone Letroy Wells Jr. | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3821 | 2020-10-16 |
| 1932707734 | Rachel Elizabeth Porrello | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-10-14 |
| 1245845551 | Alexis Feronti | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-09-14 |
| 1154935716 | Isabela N Jackson | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-09-01 |
| 1134731847 | Dawson Jazz Nimene | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3891 | 2020-08-24 |
| 1770193393 | Akil Blanton | Case Manager/Care Coordinator | 6140 S Broadway, Lorain, OH 44053-3821 | 2020-08-07 |
| Find all providers in LORAIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.