Individual
JODIE VANSACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPCC
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 204-4314
(440) 204-4315
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 204-4314
(440) 204-4315
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E-0002359
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197443
ANTHEM PIN NUMBER
OH
01
—
293764000
MAGELLAN MIS NUMBER
OH
Enumeration date
06/13/2006
Last updated
03/24/2022
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