Healthcare Provider Details

I. General information

NPI: 1679078737
Provider Name (Legal Business Name): LINDSAY DEHAAS MSW, LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 3RD ST NE
CANTON OH
44702-1167
US

IV. Provider business mailing address

405 3RD ST NE
CANTON OH
44702-1167
US

V. Phone/Fax

Practice location:
  • Phone: 330-479-6633
  • Fax: 330-775-7887
Mailing address:
  • Phone: 330-479-6633
  • Fax: 330-775-7887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1901816
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: