=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497613145
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROLLING WITH LIFE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2026
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3335 ALLENFORD DR SE
-----------------------------------------------------
City | CANTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44707-1503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-686-9734
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3335 ALLENFORD DR SE
-----------------------------------------------------
City | CANTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44707-1503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-686-9734
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/THERAPIST
-----------------------------------------------------
Name | BRIANNA SHERIDAN
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 330-705-1673
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------