| Doctor Name: | MRS. RANDI NATHENSON |
| NPI Number: | 1477719482 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW |
| License Number: | I0031534 |
| Business Practice Address: | 5564 Wilson Mills Rd Suite 201 Highland Heights, OH - 441433265 |
| Business Phone Number: | 4404611255 |
| Business Fax Number: | |
| Mailing Address: | 3654 Traver Rd, SHAKER HEIGHTS |
| State: | OH |
| Postal Code: | 441225168 |
| Phone Number: | 2169739775 |
| Fax Number: | 4404611047 |
| NPI Enumeration Date: | 07/30/2008 |
| NPI Last Update Date: | 01/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I0031534 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |