Provider Demographics
NPI:1841168978
Name:BERARDI, LORRAINE PATRICIA (LMT)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:PATRICIA
Last Name:BERARDI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 YALE AVE NW # 1
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-1765
Mailing Address - Country:US
Mailing Address - Phone:330-913-9633
Mailing Address - Fax:
Practice Address - Street 1:3978 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3043
Practice Address - Country:US
Practice Address - Phone:330-913-9633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021053225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist