| Wellness Grove Llc | |
|
4200 Munson St Nw Ste A Canton OH 44718-2981 | |
| (330) 915-2907 | |
| (330) 915-2958 |
| Full Name | Wellness Grove Llc |
|---|---|
| Speciality | Counselor |
| Location | 4200 Munson St Nw Ste A, Canton, Ohio |
| Authorized Official Name and Position | Shaun Swiger (VICE PRESIDENT & CIO) |
| Authorized Official Contact | 3309152907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Grove Llc 4200 Munson St Nw Ste A Canton OH 44718-2981 Ph: (330) 915-2907 | Wellness Grove Llc 4200 Munson St Nw Ste A Canton OH 44718-2981 Ph: (330) 915-2907 |
| NPI Number | 1043899859 |
|---|---|
| Provider Enumeration Date | 04/07/2021 |
| Last Update Date | 12/01/2022 |
| Certification Date | 12/01/2022 |
| Medicare PECOS PAC ID | 5092104109 |
|---|---|
| Medicare Enrollment ID | O20211111000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043899859 | NPI | - | NPPES |
| Provider Name | Jessica B Horvat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447363064 PECOS PAC ID: 9234268277 Enrollment ID: I20100601000000 |
| Provider Name | Maria E Hardgrove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750871513 PECOS PAC ID: 7719393644 Enrollment ID: I20210301002026 |
| Provider Name | Matthew Reese Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801387915 PECOS PAC ID: 2668825779 Enrollment ID: I20240125000414 |
| Provider Name | Rachel Gombash |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821594227 PECOS PAC ID: 2365895364 Enrollment ID: I20240125003595 |
| Provider Name | Paige Wallace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376157115 PECOS PAC ID: 9931552973 Enrollment ID: I20240126000238 |
| Provider Name | Andrew Brent Allen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306184163 PECOS PAC ID: 4789037748 Enrollment ID: I20240126000854 |
| Provider Name | Kellie E King Feciuch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609148824 PECOS PAC ID: 6305299298 Enrollment ID: I20240126002570 |
| Provider Name | Jessica Ann Headley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316450562 PECOS PAC ID: 8325437437 Enrollment ID: I20240126003013 |
| Provider Name | Madeline G Skemp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427509900 PECOS PAC ID: 2466805395 Enrollment ID: I20240126004019 |
| Provider Name | Caitlin Mcdougle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942703673 PECOS PAC ID: 8628421559 Enrollment ID: I20240126004083 |
| Provider Name | Cynthia M Cox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518588979 PECOS PAC ID: 2163875014 Enrollment ID: I20240127000366 |
| Provider Name | Jamie Sevenbergen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346733458 PECOS PAC ID: 8426401373 Enrollment ID: I20240127000394 |
| Provider Name | Cianna A Dorando |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194347328 PECOS PAC ID: 4688027535 Enrollment ID: I20240127000482 |
| Provider Name | Benjamin Nathaniel Mickey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427544626 PECOS PAC ID: 6305299256 Enrollment ID: I20240127000507 |
| Provider Name | Thomas Joseph Deiotte |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801386263 PECOS PAC ID: 2567815129 Enrollment ID: I20240130003163 |
| Provider Name | Brittany Jenyse Franklin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053823633 PECOS PAC ID: 3870946452 Enrollment ID: I20240131000382 |
| Provider Name | Joseph Kury |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700444676 PECOS PAC ID: 5294188793 Enrollment ID: I20240131004565 |
| Provider Name | Christy Ann Ward |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134716202 PECOS PAC ID: 1456704964 Enrollment ID: I20240131005031 |
| Provider Name | Shannon M. Woodard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639539059 PECOS PAC ID: 2163867029 Enrollment ID: I20240301000164 |
| Provider Name | Pamela Ann Ebert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467711580 PECOS PAC ID: 0547688616 Enrollment ID: I20240306002228 |
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