Healthcare Provider Details

I. General information

NPI: 1437548914
Provider Name (Legal Business Name): JENNIFER FINNEGIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6279 FRANK AVE NW
NORTH CANTON OH
44720-7227
US

IV. Provider business mailing address

10100 ELIDA RD
DELPHOS OH
45833-9056
US

V. Phone/Fax

Practice location:
  • Phone: 330-305-1668
  • Fax: 330-305-1696
Mailing address:
  • Phone: 419-685-8010
  • Fax: 419-932-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1400572-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0500696
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1400572
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: