| Vista Psychological & Counseling Centre Llc | |
|
1201 South Main St Suite 100 North Canton OH 44720 | |
| (330) 244-8782 | |
| (330) 244-8795 |
| Full Name | Vista Psychological & Counseling Centre Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1201 South Main St, North Canton, Ohio |
| Authorized Official Name and Position | Robert A Humphries (PSYCHOLOGIST) |
| Authorized Official Contact | 3302448782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Psychological & Counseling Centre Llc 1201 South Main St Suite 100 North Canton OH 44720 Ph: (330) 244-8782 | Vista Psychological & Counseling Centre Llc 1201 South Main St Suite 100 North Canton OH 44720 Ph: (330) 244-8782 |
| NPI Number | 1558535658 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 07/17/2014 |
| Medicare PECOS PAC ID | 2365517836 |
|---|---|
| Medicare Enrollment ID | O20080818000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558535658 | NPI | - | NPPES |
| Provider Name | Stephanie A Bradford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710900303 PECOS PAC ID: 2062446925 Enrollment ID: I20050921000309 |
| Provider Name | Robert A Humphries |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447319181 PECOS PAC ID: 0345315818 Enrollment ID: I20080818000611 |
| Provider Name | Michael Benoit |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750699567 PECOS PAC ID: 4880838846 Enrollment ID: I20130913000423 |
| Provider Name | Angela Nicole Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558768366 PECOS PAC ID: 3678898491 Enrollment ID: I20150218001945 |
| Provider Name | Tara L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821118530 PECOS PAC ID: 3870846611 Enrollment ID: I20181128003282 |
| Provider Name | Michelle Foraker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639258874 PECOS PAC ID: 0749631018 Enrollment ID: I20240111000286 |
| Provider Name | Bridgette C Cruickshank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619352119 PECOS PAC ID: 4880045194 Enrollment ID: I20240111001763 |
| Provider Name | Jenna Humphries |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760084222 PECOS PAC ID: 6406208396 Enrollment ID: I20240116003513 |
| Provider Name | Kelsey Raymondi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396407326 PECOS PAC ID: 0840642732 Enrollment ID: I20240116003554 |
| Provider Name | Julia L Appleby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699835280 PECOS PAC ID: 5799902136 Enrollment ID: I20240221001661 |
| Provider Name | Erika C Irwin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649825399 PECOS PAC ID: 7214371970 Enrollment ID: I20240221001771 |
| Provider Name | Virginia P Cole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720522345 PECOS PAC ID: 2961848551 Enrollment ID: I20240305004250 |
| Provider Name | Jason Mogus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528503067 PECOS PAC ID: 2163869694 Enrollment ID: I20240320001505 |
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