Lori Jean Radwancky, PRS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

APS.003762 Issued in OH

Practice address

7301 Ravenna Rd
Concord Township, OH 44077-8928

Phone

(440) 205-2684

NPI assigned

Jan 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1033822242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12345 CLARIDON TROY RD",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440248445",
            "telephone_number": "440-228-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 RAVENNA RD",
            "city": "CONCORD TOWNSHIP",
            "state": "OH",
            "postal_code": "440778928",
            "telephone_number": "440-205-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADWANCKY",
        "first_name": "LORI",
        "middle_name": "JEAN",
        "credential": "PRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "APS.003762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lradwancky@lgrc.us",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "7301 Ravenna Rd",
            "city": "Concord Township",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440778928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Concord Township, OH
• Providers in Concord Township, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.