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NPI Code Detail

MEDICARE: MR. GERALD B VINSON LISW

MEDICARE:  MR. GERALD B VINSON  LISW
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
1101YA0400XAddiction (Substance Use Disorder) CounselorI0002192OH
2101YP2500XProfessional CounselorI0002192OH
3101YM0800XMental Health CounselorI0002192OH

General Provider Information

NPI Number : 1801089172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GERALD B VINSON LISW
Provider Business Mailing Address
First Line : 1735 S HAWKINS AVE STE A
Second Line :
City : AKRON
State : OH
Zip : 44320-3902
Country : US
Telephone Number : 330-867-5400
Fax Number : 330-454-4357
Provider Business Practice Location Address
First Line : 1735 S HAWKINS AVE STE A
Second Line :
City : AKRON
State : OH
Zip : 44320
Country : US
Telephone Number : 330-867-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2007
Last Update Date : 07/02/2019

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Directions to “ MR. GERALD B VINSON LISW” Practice Location

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