Healthcare Provider Details

I. General information

NPI: 1275496606
Provider Name (Legal Business Name): KRISTY CURRENCE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 W MAPLE ST STE 102
NORTH CANTON OH
44720-2858
US

IV. Provider business mailing address

1303 W MAPLE ST STE 102
NORTH CANTON OH
44720-2858
US

V. Phone/Fax

Practice location:
  • Phone: 330-574-9134
  • Fax: 330-775-7889
Mailing address:
  • Phone: 330-574-9134
  • Fax: 330-775-7889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2607986
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS.0500121
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: