| Joshua Prince, LPCC | |
|
4522 Fulton Dr Nw, Canton, OH 44718-2332 | |
| (330) 915-2907 | |
| (330) 915-2958 |
| Full Name | Joshua Prince |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 6 Years |
| Location | 4522 Fulton Dr Nw, Canton, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962025718 | NPI | - | NPPES |
| 0405088 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | C.2103132 (Ohio) | Secondary |
| 101YM0800X | Counselor - Mental Health | E.2606065 (Ohio) | Secondary |
| 101YP2500X | Counselor - Professional | E.2606065 (Ohio) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellness Grove Llc | 5092104109 | 25 |
| Entity Name | Wellness Grove LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043899859 PECOS PAC ID: 5092104109 Enrollment ID: O20211111000586 |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua Prince, LPCC 4522 Fulton Dr Nw, Canton, OH 44718-2332 Ph: (330) 915-2907 | Joshua Prince, LPCC 4522 Fulton Dr Nw, Canton, OH 44718-2332 Ph: (330) 915-2907 |
Joseph N Lockett, LICDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 Fax: 330-453-6716 |
Amy Nelson, CT, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 |
Hillary A Whiteman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 Fax: 330-453-6716 |
Brendan Rowe, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 624 Market Ave N, Canton, OH 44702 Phone: 330-493-4553 Fax: 330-493-3761 |
Obiageri Ebere Ngwaogu, CT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1341 Market Ave N, Canton, OH 44714 Phone: 330-453-8252 Fax: 330-452-4655 |
Alexis Gibbs, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4522 Fulton Dr Nw, Canton, OH 44718 Phone: 330-915-2907 Fax: 330-915-2958 |
Kilee Shawd-sopko, CT Counselor Medicare: Not Enrolled in Medicare Practice Location: 4522 Fulton Dr Nw, Canton, OH 44718 Phone: 330-915-2907 Fax: 330-915-2958 |