Healthcare Provider Details

I. General information

NPI: 1588042352
Provider Name (Legal Business Name): BRIAN STRAWN LPCC-S LICDC-CS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NORTH AVE NE STE B
MASSILLON OH
44646-5510
US

IV. Provider business mailing address

410 MARLYN PKWY NE
MASSILLON OH
44646-4862
US

V. Phone/Fax

Practice location:
  • Phone: 330-575-5300
  • Fax: 855-273-7554
Mailing address:
  • Phone: 330-575-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1901129
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number150330
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1500090
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: