Healthcare Provider Details

I. General information

NPI: 1922873421
Provider Name (Legal Business Name): JAMES W STOREY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 BAUGHMAN RD
CLINTON OH
44216-9331
US

IV. Provider business mailing address

2828 BAUGHMAN RD
NEW FRANKLIN OH
44216-9331
US

V. Phone/Fax

Practice location:
  • Phone: 330-221-2944
  • Fax:
Mailing address:
  • Phone: 330-221-2944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRS.007857
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: