Healthcare Provider Details

I. General information

NPI: 1437827722
Provider Name (Legal Business Name): DREW HERSHBERGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 09/18/2023
Certification Date: 09/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3745 WHIPPLE AVE NW STE A
CANTON OH
44718-4805
US

IV. Provider business mailing address

624 MARKET AVE N
CANTON OH
44702-1017
US

V. Phone/Fax

Practice location:
  • Phone: 330-331-7506
  • Fax:
Mailing address:
  • Phone: 330-493-4553
  • Fax: 330-493-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: