Healthcare Provider Details

I. General information

NPI: 1972353860
Provider Name (Legal Business Name): SHIFT COUNSELING & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5212 MAHONING AVE STE 311
YOUNGSTOWN OH
44515-1857
US

IV. Provider business mailing address

5212 MAHONING AVE STE 311
YOUNGSTOWN OH
44515-1857
US

V. Phone/Fax

Practice location:
  • Phone: 330-391-7374
  • Fax:
Mailing address:
  • Phone: 330-391-7374
  • Fax: 330-294-1774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR MARIE BROWN
Title or Position: FOUNDER & PSYCHOTHERAPIST
Credential:
Phone: 330-391-7374