Andrea Razavi, L.P.C.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E1000304 Issued in OH

Practice address

137 N. Main Street
Suite 7
Chardon, OH 44024-1152

Phone

(216) 870-7112

NPI assigned

Aug 22, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Family Pride of Northeast Ohio Incorporated

  • Community/Behavioral Health Agency
  • Chardon, OH
  • NPI 1427013556
  Medicare reassignment NPD
• Family Pride of Northeast Ohio Incorporated

  • Community/Behavioral Health Agency
  • Chardon, OH
  • NPI 1881049807
  NPD (past)

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1760881031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N. MAIN STREET",
            "address_2": "SUITE 7",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241152",
            "telephone_number": "216-870-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 N. MAIN STREET",
            "address_2": "SUITE 7",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241152",
            "telephone_number": "216-870-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZAVI",
        "first_name": "ANDREA",
        "credential": "L.P.C.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E1000304",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E1000304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravenwood Mental Health Center
• Ravenwood Mental Health Center
• Ravenwood Mental Health Center
• Ravenwood Mental Health Center
• Leah Ray
• William Shane Reagan
• Paige Reale
• Haarika Reddy
• Danny Lee Reed
• Diana Reed

• Mental Health Counselor in Chardon, OH
• Providers in Chardon, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.