MEDICARE: DR. LAUREL BRISBIN-SHEPLER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4599	OH
2	103TB0200X	Cognitive & Behavioral Psychologist	4599	OH
3	103TC0700X	Clinical Psychologist	4599	OH
4	103TC1900X	Counseling Psychologist	4599	OH
5	103TC2200X	Clinical Child & Adolescent Psychologist	4599	OH
6	103TF0000X	Family Psychologist	4599	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669536314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREL BRISBIN-SHEPLER PH.D.

Provider Business Mailing Address
First Line	:	2795 FRONT ST
Second Line	:	SUITE A
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44221-1900
Country	:	US
Telephone Number	:	330-945-7100
Fax Number	:	330-945-4305

Provider Business Practice Location Address
First Line	:	4347 PORTAGE ST NW
Second Line	:	SUITE 103
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-7371
Country	:	US
Telephone Number	:	330-945-7100
Fax Number	:	330-945-4305

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	09/11/2025

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Directions to “ DR. LAUREL BRISBIN-SHEPLER PH.D.” Practice Location

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