RAVENWOOD MENTAL HEALTH CENTER (NPI# 1912265794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912265794 |
| Entity Type | Organization |
| Organization Name | RAVENWOOD MENTAL HEALTH CENTER |
| Practice Address |
12557 Ravenwood Dr Chardon OH 44024-9009 |
| Practice Telephone | 4402852170 |
| Practice Fax Number | 4402852207 |
| Mailing Telephone | 4402852170 |
| Mailing Fax Number | 4402852207 |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2014-10-14 |
| Authorized Official Name | VICKI L CLARK (CEO) |
| Authorized Official Telephone | 4402852170 |
| Authorized Official Credential | LPCC-S, CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
OH | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | NPI | 1053345975 | 01 |
| OH | 2863763 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666740 | Ravenwood Mental Health Center | General Practice | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2019-02-28 |
| 1770882896 | Ravenwood Mental Health Center | Case Management | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2011-03-16 |
| 1861705212 | Ravenwood Mental Health Center | Health Maintenance Organization | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2010-07-14 |
| 1497068845 | Ravenwood Mental Health Center | Community/Behavioral Health | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2010-07-14 |
| 1730356296 | Ravenwood Mental Health Center | Community/Behavioral Health | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2008-05-14 |
| 1558403451 | Ravenwood Mental Health Center | Community/Behavioral Health | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2007-02-14 |
| 1053345975 | Ravenwood Mental Health Center | Clinic/Center | 12557 Ravenwood Dr, Chardon, OH 44024 | 2006-07-10 |
| Street Address |
12557 RAVENWOOD DR |
| City | CHARDON |
| State | OH |
| Zip Code | 44024-9009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831176676 | Linda Folan | Social Worker | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2005-12-22 |
| 1720687213 | Lauren Marie Sell | Case Manager/Care Coordinator | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-10-26 |
| 1780283465 | Rachael Wilson | Case Manager/Care Coordinator | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-10-22 |
| 1427656347 | Rebecca Moore | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-10-13 |
| 1518565423 | Hallie Ortiz | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-10-13 |
| 1922610815 | Christina M Charlillo | Case Manager/Care Coordinator | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-08-20 |
| 1689284093 | Ian Michael Dewalt | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-08-01 |
| 1134745672 | Briana Salgado | Case Manager/Care Coordinator | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-06-21 |
| 1689296642 | Samantha Louise Simpkins | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-05-13 |
| 1760004741 | Rebecca Rayner | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2020-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992336770 | Amanda Nicole Nelson | Technician, Other | 133 Up Main St, Chardon, OH 44024 | 2020-01-30 |
| 1679067011 | Janai Marshae Seng | Dentist | 401 South Street #3a, Chardon, OH 44024 | 2018-06-19 |
| 1376036475 | Kasandra Leigh Chapman | Social Worker | 12941 Ravenna Road, Chardon, OH 44024 | 2018-06-13 |
| 1275068652 | Danielle Tilton | Nurse Practitioner | 531 Fifth Ave, Chardon, OH 44024 | 2017-04-24 |
| 1881057040 | Erin Marie Moore | Counselor | 203 Main St., Chardon, OH 44024 | 2016-04-04 |
| 1649689886 | Hope Anne Super | Speech-Language Pathologist | 100 7th Av Suite 255, Chardon, OH 44024 | 2014-08-12 |
| 1740600022 | Elisha Tzvi Fredman | Student in an Organized Health Care Education/Training Program | 13207 Chardon Road, Ravenna, OH 44024 | 2014-04-24 |
| 1083039309 | Jamie Delvecchio | Family Medicine | 150 7th Ave Ste 200, Chardon, OH 44024 | 2014-02-24 |
| 1174947212 | Frank Scarano | Psychologist | 470 Center Street, Chardon, OH 44024 | 2014-02-10 |
| 1659706497 | Jamie Henderson | Physical Therapy Assistant | 9348 South Brown Rd, Chardon, OH 44024 | 2013-09-12 |
| Find all providers in zip 44024 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538345335 | Bernadette M Charles | Counselor | 695 South St, Chardon, OH 44024-1474 | 2008-01-11 |
| 1093875544 | Sandra E Bruss | Counselor | 13000 Auburn Rd, Chardon, OH 44024-9337 | 2006-12-12 |
| 1346888047 | Edward J Morell | Counselor | 602 South St Ste D-1, Chardon, OH 44024-1499 | 2019-12-13 |
| 1992355481 | Everett Buddenberg | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2019-09-17 |
| 1356872733 | James Alexis Konnoff | Counselor | 209 Center St, Chardon, OH 44024-1189 | 2017-03-27 |
| 1720441892 | Heather Baur | Counselor | 695 South St Ste 6, Chardon, OH 44024-1474 | 2016-04-05 |
| 1336454123 | Holly M Zwolinski | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2010-08-17 |
| 1962644740 | Eve Louise Smith | Counselor | 10771 Mayfield Rd, Chardon, OH 44024-9323 | 2009-03-25 |
| 1619044708 | Carla J Gilenko | Counselor | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2006-11-30 |
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| 1861093254 | Innovative Wellness LLC | Counselor | 4985 Smoketalk Ln, Westerville, OH 43081-4432 | 2020-11-03 |
| 1619578275 | Steps To Wellness, Inc. | Counselor | 3577 East 144h Street, Cleveland, OH 44120 | 2020-11-02 |
| 1215537493 | Christine Moran | Counselor | 3092 W 155th St, Cleveland, OH 44111-1029 | 2020-10-28 |
| 1790384220 | Ron Lee Ward | Counselor | 950 E Alex Bell Rd Ste 100, Centerville, OH 45459-2721 | 2020-10-26 |
| 1669071023 | Tyra S Rice | Counselor | 25 W Rayen Ave Apt 503, Youngstown, OH 44503-1022 | 2020-10-18 |
| 1669070033 | Charismata Counseling LLC | Counselor | 2670 N Columbus St Ste 0, Lancaster, OH 43130-8408 | 2020-10-16 |
| 1467050427 | Sonia Buhrer Bowen | Counselor | 475 E Mound St, Columbus, OH 43215-5573 | 2020-10-13 |
| 1750989737 | Renea Yvonne Jagel | Counselor | 4711 Nebraska Ave, Huber Heights, OH 45424-6003 | 2020-10-13 |
| 1114524741 | Amanda Jo Sharp | Counselor | 500 Lehman Ave Ste 100, Bowling Green, OH 43402-3068 | 2020-10-06 |
| 1689271546 | Laura Frericks | Counselor | 4577 Frederick Pike Apt D, Dayton, OH 45414-3940 | 2020-10-05 |
| Find all providers with the same taxonomy | ||||
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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.