Provider Demographics
NPI:1558532994
Name:LADRACH, LOUREE L (LISW, LICDC)
Entity Type:Individual
Prefix:MRS
First Name:LOUREE
Middle Name:L
Last Name:LADRACH
Suffix:
Gender:F
Credentials:LISW, LICDC
Other - Prefix:MRS
Other - First Name:LOUREE
Other - Middle Name:L
Other - Last Name:EDINGTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW LICDC
Mailing Address - Street 1:104 SPINK ST
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-3652
Mailing Address - Country:US
Mailing Address - Phone:330-264-8498
Mailing Address - Fax:
Practice Address - Street 1:104 SPINK ST
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-3652
Practice Address - Country:US
Practice Address - Phone:330-264-8498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI8376, 933766101YA0400X
OHI8376101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health