Healthcare Provider Details

I. General information

NPI: 1023889649
Provider Name (Legal Business Name): MICHAEL GAMBLE PHD, AMP, CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 S MAIN ST STE 210
AKRON OH
44311-4401
US

IV. Provider business mailing address

526 S MAIN ST STE 210
AKRON OH
44311-4401
US

V. Phone/Fax

Practice location:
  • Phone: 330-474-9601
  • Fax:
Mailing address:
  • Phone: 330-474-9601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: