Individual provider Active NPI

Deborah Park, IMFT

  • Marriage & Family Therapist
  • Canton, OH
National Provider Identifier
1093926586
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMFT F0500019 Issued in OH
Practice address
527 30TH St NW
Canton, OH 44709-3109
Phone
(330) 313-1213
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMFT F0500019 OH Primary

Addresses

Primary practice location

527 30TH St NW
Canton, OH 44709-3109

Mailing address

527 30TH St NW
Canton, OH 44709-3109
Phone (330) 313-1213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMFT F0500019OHMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093926586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 30TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093109",
            "telephone_number": "330-313-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 30TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093109",
            "telephone_number": "330-313-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DEBORAH",
        "credential": "IMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "IMFT F0500019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.