Provider Demographics
NPI:1346061538
Name:ROMANCHIK, JAMES MARTIN JR (CDCA-PRE)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MARTIN
Last Name:ROMANCHIK
Suffix:JR
Gender:M
Credentials:CDCA-PRE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5965 BONETA RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8760
Mailing Address - Country:US
Mailing Address - Phone:440-465-7043
Mailing Address - Fax:
Practice Address - Street 1:127 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-4395
Practice Address - Country:US
Practice Address - Phone:330-636-1741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.190333101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)