Individual provider Active NPI

L. Allyson Radenheimer, MA, LPC

  • Professional Counselor
  • Saint Albans, WV
National Provider Identifier
1669597936
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2448 Issued in WV
Practice address
200 Kanawha Ter Ste 2
Saint Albans, WV 25177-2808
Phone
(304) 760-9945
NPI assigned
Mar 19, 2007
Last updated
Jul 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2448 WV Primary

Addresses

Primary practice location

200 Kanawha Ter Ste 2
Saint Albans, WV 25177-2808

Mailing address

PO Box 172
Culloden, WV 25510-0172
Phone (304) 760-9945

Other identifiers 1

IdentifierTypeStateIssuer
1065OtherKYFIRST STEPS CBIS

Other names 1

  • Lynn Allyson Radenheimer Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2448WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Just Breathe Therapy, LLC Professional CurrentSince Dec 1, 2024 Accepting new patients
Aspire to Inspire Behavioral Health and Addiction Services, LLC Professional PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1669597936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172",
            "city": "CULLODEN",
            "state": "WV",
            "postal_code": "255100172",
            "telephone_number": "304-760-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 KANAWHA TER STE 2",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772808",
            "telephone_number": "304-760-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADENHEIMER",
        "first_name": "L.",
        "middle_name": "ALLYSON",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST STEPS CBIS",
            "identifier": "1065",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "RADENHEIMER",
            "middle_name": "ALLYSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Albans, WV

Sources for this page

Verify at the official NPI Registry.