Healthcare Provider Details

I. General information

NPI: 1356258321
Provider Name (Legal Business Name): JOHNATHON ARMSTRONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 W MAIN ST
SHELBY OH
44875-1439
US

IV. Provider business mailing address

1579 OLD BOWMAN ST
MANSFIELD OH
44903-8805
US

V. Phone/Fax

Practice location:
  • Phone: 567-292-9285
  • Fax:
Mailing address:
  • Phone: 419-544-1677
  • Fax: 419-544-1677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: