Provider Demographics
NPI:1598012858
Name:ROVNYAK, ADRIA (LISW-S)
Entity type:Individual
Prefix:
First Name:ADRIA
Middle Name:
Last Name:ROVNYAK
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 NORTH RD.
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446
Mailing Address - Country:US
Mailing Address - Phone:330-652-6770
Mailing Address - Fax:330-652-2069
Practice Address - Street 1:29 NORTH RD.
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446
Practice Address - Country:US
Practice Address - Phone:330-652-6770
Practice Address - Fax:330-652-2069
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1200514104100000X
OHI.17002481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0236655Medicaid