| Restore Compassionate Behavioral Health | |
|
725 Boardman Canfield Rd Ste L1 Youngstown OH 44512 | |
| (234) 254-0612 | |
| Not Available |
| Full Name | Restore Compassionate Behavioral Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 725 Boardman Canfield Rd Ste L1, Youngstown, Ohio |
| Authorized Official Name and Position | Rajendra P Koirala (OWNER) |
| Authorized Official Contact | 2342540612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Compassionate Behavioral Health 725 Boardman Canfield Rd Ste L1 Boardman OH 44512-4370 Ph: (234) 254-0612 | Restore Compassionate Behavioral Health 725 Boardman Canfield Rd Ste L1 Youngstown OH 44512 Ph: (234) 254-0612 |
| NPI Number | 1760977177 |
|---|---|
| Provider Enumeration Date | 06/27/2018 |
| Last Update Date | 06/29/2018 |
| Medicare PECOS PAC ID | 8820334931 |
|---|---|
| Medicare Enrollment ID | O20190110002117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760977177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 35.091058 (Ohio) | Primary |
| Provider Name | Rajendra P Koirala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952588972 PECOS PAC ID: 8426133885 Enrollment ID: I20090206000156 |
| Provider Name | Kathleen Shannon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225137219 PECOS PAC ID: 9234278375 Enrollment ID: I20091202000260 |
| Provider Name | David B Noll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992919591 PECOS PAC ID: 4183724149 Enrollment ID: I20101008000330 |
| Provider Name | Kassandra Sue Kornbau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447596564 PECOS PAC ID: 5092955492 Enrollment ID: I20130708000756 |
| Provider Name | Susan M Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336470715 PECOS PAC ID: 3678884459 Enrollment ID: I20150619001774 |
| Provider Name | Leslie M Markulin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609269240 PECOS PAC ID: 2961718770 Enrollment ID: I20150824002553 |
| Provider Name | Anna R Hawout |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659824993 PECOS PAC ID: 8527348952 Enrollment ID: I20170623001571 |
| Provider Name | Lareane Nuby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770936809 PECOS PAC ID: 5597037465 Enrollment ID: I20170828002257 |
| Provider Name | Katherine C Komara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316480866 PECOS PAC ID: 4082980883 Enrollment ID: I20171023002723 |
| Provider Name | Sarah Cercone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669791315 PECOS PAC ID: 0446685077 Enrollment ID: I20200108002440 |
| Provider Name | Jessica Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184776692 PECOS PAC ID: 0749616464 Enrollment ID: I20200128002370 |
| Provider Name | Rachael Mcpheron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710382098 PECOS PAC ID: 4385066505 Enrollment ID: I20200617000342 |
| Provider Name | Ryan J Goettsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215485990 PECOS PAC ID: 7012321003 Enrollment ID: I20210203000855 |
| Provider Name | Nicole Pondillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285220913 PECOS PAC ID: 4880001064 Enrollment ID: I20210406001745 |
| Provider Name | Cara Wecht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881027688 PECOS PAC ID: 4284037995 Enrollment ID: I20210719002031 |
| Provider Name | Jodi Lynn Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518486745 PECOS PAC ID: 9133462286 Enrollment ID: I20210903002303 |
| Provider Name | Kerrigan M Skruck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386290823 PECOS PAC ID: 1850760018 Enrollment ID: I20221209000693 |
| Provider Name | Megan Mulligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629783774 PECOS PAC ID: 7113399189 Enrollment ID: I20230221001880 |
| Provider Name | Kelsey Demart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932725041 PECOS PAC ID: 2567810138 Enrollment ID: I20231121002456 |
| Provider Name | Laura Diblasio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427594241 PECOS PAC ID: 8527416403 Enrollment ID: I20231204001033 |
| Provider Name | Cynthia Zeisler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689983470 PECOS PAC ID: 4880042779 Enrollment ID: I20231204001158 |
| Provider Name | Kayla Beary |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871039941 PECOS PAC ID: 8921457367 Enrollment ID: I20231212000332 |
| Provider Name | Valerie Prevosnak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871929786 PECOS PAC ID: 0244688265 Enrollment ID: I20240212002008 |
| Provider Name | Catherine Dye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568007839 PECOS PAC ID: 0345686614 Enrollment ID: I20240308000959 |
| Provider Name | Taylor M Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427663608 PECOS PAC ID: 7719323575 Enrollment ID: I20240314003375 |
| Provider Name | Tara Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083101372 PECOS PAC ID: 7810334331 Enrollment ID: I20240320000998 |
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