Healthcare Provider Details

I. General information

NPI: 1699033084
Provider Name (Legal Business Name): JOHN T. A. DEVLIN LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 03/27/2021
Certification Date: 03/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6659 FRANK AVE NW
NORTH CANTON OH
44720-7259
US

IV. Provider business mailing address

4368 DRESSLER RD. NW, SUITE 103
CANTON OH
44718
US

V. Phone/Fax

Practice location:
  • Phone: 330-433-1300
  • Fax: 330-494-0828
Mailing address:
  • Phone: 330-433-7130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE-0500678-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: