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NPI Code Detail

MEDICARE: ANDREW JAMES TELSHAW

MEDICARE: ANDREW JAMES TELSHAW
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.192702

General Provider Information

NPI Number : 1063376358
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW JAMES TELSHAW
Provider Business Mailing Address
First Line : 143 GOUGLER AVE
Second Line :
City : KENT
State : OH
Zip : 44240-2401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 143 GOUGLER AVE
Second Line :
City : KENT
State : OH
Zip : 44240-2401
Country : US
Telephone Number : 330-673-1016
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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Directions to “ ANDREW JAMES TELSHAW ” Practice Location

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