Healthcare Provider Details

I. General information

NPI: 1760045934
Provider Name (Legal Business Name): JANELLE PARIS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 12/29/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4429 FULTON DR NW UNIT 8
CANTON OH
44718-2867
US

IV. Provider business mailing address

4429 FULTON DR NW UNIT 8
CANTON OH
44718-2867
US

V. Phone/Fax

Practice location:
  • Phone: 330-778-2919
  • Fax:
Mailing address:
  • Phone: 330-778-2919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1901139
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: