Healthcare Provider Details

I. General information

NPI: 1063847119
Provider Name (Legal Business Name): ANN MARIE GEBHARDT LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8256 E MARKET ST STE 115
WARREN OH
44484-2300
US

IV. Provider business mailing address

8256 E MARKET ST STE 115
WARREN OH
44484-2300
US

V. Phone/Fax

Practice location:
  • Phone: 330-469-2312
  • Fax:
Mailing address:
  • Phone: 330-469-2312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC1200170
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: