MEDICARE: AMRESTORATIVE COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1053102277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMRESTORATIVE COUNSELING LLC

Provider Business Mailing Address
First Line	:	610 N MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2007
Country	:	US
Telephone Number	:	330-936-0438
Fax Number	:	234-425-5843

Provider Business Practice Location Address
First Line	:	610 N MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2007
Country	:	US
Telephone Number	:	330-353-8661
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	KIMBERLY BALL
Credential	:
Telephone Number	:	330-936-0438

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	12/09/2025

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Directions to “AMRESTORATIVE COUNSELING LLC ” Practice Location

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