MEDICARE: MICHELLE GARY LPCC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	E.1901168	OH

General Provider Information

NPI Number	:	1265888085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE GARY LPCC

Provider Business Mailing Address
First Line	:	6545 MARKET AVE N
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6545 MARKET AVE N
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:	330-310-1803
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2016
Last Update Date	:	03/07/2026

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Directions to “ MICHELLE GARY LPCC” Practice Location

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