Healthcare Provider Details

I. General information

NPI: 1225754161
Provider Name (Legal Business Name): WANTING ZHAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 S BROADWAY
LORAIN OH
44053-3891
US

IV. Provider business mailing address

6140 S BROADWAY
LORAIN OH
44053-3891
US

V. Phone/Fax

Practice location:
  • Phone: 440-233-7232
  • Fax: 440-282-4779
Mailing address:
  • Phone: 440-233-7232
  • Fax: 440-282-4779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.162787
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2606770
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: