Miranda Fedor

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

179950 Issued in OH

Practice address

205 Wadsworth Rd
Wadsworth, OH 44281-9580

Phone

(234) 217-8882

NPI assigned

Nov 8, 2022

Last updated

Nov 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1861100943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5078 HONEYSTONE CIR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442566596",
            "telephone_number": "330-410-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WADSWORTH RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819580",
            "telephone_number": "234-217-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOR",
        "first_name": "MIRANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "179950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Practice Center of Wadsworth Inc
• Family Statcare of Northeast Ohio, LLC
• Theresa Ann Farello, LPCC
• Melissa Renne Farnsworth, LMT
• Joanna Farragher, CNP
• James Ferguson
• Todd David Ferguson, DDS
• Melanie Fetter, APRN
• Wendy Sue Fickey
• Kataria D Fidler

• Addiction (Substance Use Disorder) Counselor in Wadsworth, OH
• Providers in Wadsworth, 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 Nov 8, 2022; 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.