Healthcare Provider Details

I. General information

NPI: 1366224503
Provider Name (Legal Business Name): PINNACLE HEALTHY MIND PROVIDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 3RD ST SW
CANTON OH
44702-1607
US

IV. Provider business mailing address

4580 STEPHENS CIR NW STE 202
CANTON OH
44718-3645
US

V. Phone/Fax

Practice location:
  • Phone: 330-754-4431
  • Fax: 330-244-8839
Mailing address:
  • Phone: 330-754-4431
  • Fax: 330-244-8839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MCCLAIN
Title or Position: CEO
Credential: MD
Phone: 330-754-4431