Individual provider Active NPI

Marisa Fatica-Rogaski, LPCC

  • Mental Health Counselor
  • Chardon, OH
National Provider Identifier
1275058018
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.1700364 Issued in OH
Practice address
521 Fifth Ave Ste 2
Chardon, OH 44024-1088
Phone
(440) 286-1553
NPI assigned
Aug 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X E.1700364 OH Primary

Addresses

Primary practice location

521 Fifth Ave Ste 2
Chardon, OH 44024-1088

Mailing address

521 Fifth Ave Unit a
Chardon, OH 44024-1088
Phone (440) 286-1553

Other practice location 1

3518 W 25th St
Cleveland, OH 44109-1951
Phone (216) 741-2241 ext. 1273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523002791 OH Practitioner - Mental Health Counselor 2365884293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Pride of Northeast Ohio IncorporatedGroup PAC ID 9739458589, 11 clinicians

Practice addresses (Care Compare)

521 5TH Ave
Suite a
Chardon, OH 44024-1088
Phone (440) 286-1553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.1700364OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ravenwood Mental Health Center Current Accepting new patients
Family Pride of Northeast Ohio Incorporated CurrentSince Jun 1, 2025 Accepting new patients
Ravenwood Mental Health Center CurrentSince Apr 7, 2024 Accepting new patients
Ravenwood Mental Health Center CurrentSince Apr 7, 2024 Accepting new patients

Locations

521 5th Ave
Ste A
Chardon, OH 44024
Phone (440) 286-1553

12557 Ravenwood Dr
Concord Twp, OH 44024
Phone (440) 990-6104

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/familyprideonline/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1275058018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 FIFTH AVE UNIT A",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241088",
            "telephone_number": "440-286-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 FIFTH AVE STE 2",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241088",
            "telephone_number": "440-286-1553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3518 W 25th St",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091951",
            "country_code": "US",
            "telephone_number": "216-741-2241 x1273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATICA-ROGASKI",
        "first_name": "MARISA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-12",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1700364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.