Healthcare Provider Details

I. General information

NPI: 1063843993
Provider Name (Legal Business Name): STEPHANIE WHEATLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 N FORGE ST
AKRON OH
44304-1317
US

IV. Provider business mailing address

18 N FORGE ST
AKRON OH
44304-1317
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-0591
  • Fax:
Mailing address:
  • Phone: 330-762-0591
  • Fax: 330-762-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1902139
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: