Healthcare Provider Details

I. General information

NPI: 1447062872
Provider Name (Legal Business Name): AMANDA WOZNIAK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15887 SNOW RD STE 301
BROOKPARK OH
44142-2854
US

IV. Provider business mailing address

5728 WELLESLEY AVE
NORTH OLMSTED OH
44070-3956
US

V. Phone/Fax

Practice location:
  • Phone: 216-714-3128
  • Fax:
Mailing address:
  • Phone: 716-481-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.188909
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2506738
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: