Healthcare Provider Details

I. General information

NPI: 1669536314
Provider Name (Legal Business Name): LAUREL BRISBIN-SHEPLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4347 PORTAGE ST NW SUITE 103
NORTH CANTON OH
44720-7371
US

IV. Provider business mailing address

2795 FRONT ST SUITE A
CUYAHOGA FALLS OH
44221-1900
US

V. Phone/Fax

Practice location:
  • Phone: 330-945-7100
  • Fax: 330-945-4305
Mailing address:
  • Phone: 330-945-7100
  • Fax: 330-945-4305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4599
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4599
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4599
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number4599
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4599
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number4599
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: