Realize Your Path LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REALIZE YOUR PATH LLC

Practice address

21245 Lorain Rd Ste 201
Fairview Park, OH 44126-2140

Phone

(216) 337-3189

NPI assigned

Aug 31, 2018

Organization subpart

No

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

Authorized official

Name

Airielle Siobhan Banaszak, LISW-SNPI 1780128959

Title

Owner

Phone

(216) 337-3189

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Airielle Banaszak, LISW-S

  • Clinical Social Worker
  • Fairview Park, OH
  • NPI 1780128959
  Medicare reassignment NPD Authorized official
• Sarah Jane Kenney, LISW

  • Clinical Social Worker
  • Fairview Park, OH
  • NPI 1154771525
  NPD (past)

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1750863288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21245 LORAIN RD STE 201",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262140",
            "telephone_number": "216-337-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21245 LORAIN RD STE 201",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262140",
            "telephone_number": "216-337-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALIZE YOUR PATH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-31",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "BANASZAK",
        "authorized_official_first_name": "AIRIELLE",
        "authorized_official_middle_name": "SIOBHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-337-3189",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Helen Potts, M.A., CCC-A
• Colette Pritchard, CDCA, CT
• Judith L Ptaszek, M.S. CCC-SLP
• Pulmtech, LLC
• Richard E Ranchoff, MD
• Rec2Connect, LLC
• Jill Marie Reese, RPH
• Marsha Bennet Regan, LISW
• Tracy E. Reinoso, LPN
• Edwin Tan Reyes, DDS

• Clinical Social Worker in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.