=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578490777
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROANE THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5020 COLLEGE CORNER PIKE STE A1
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45056-1162
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-549-0646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 18951
-----------------------------------------------------
City | FAIRFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45018-0951
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-549-0646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED INDEPENDENT SOCIAL WORKER
-----------------------------------------------------
Name | NANCY LEE ROANE
-----------------------------------------------------
Credential | LISW
-----------------------------------------------------
Telephone | 513-549-0646
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------