Individual provider Active NPI

Cynthia Diane Rudick, PHD

  • Mental Health Counselor
  • Canton, OH
National Provider Identifier
1144335647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E144 Issued in OH
Practice address
3722 Whipple Ave NW
Canton, OH 44718-2934
Phone
(330) 492-2006
Fax
(330) 492-2161
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

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
Mental Health Counselor 101YM0800X E144 OH Primary

Addresses

Primary practice location

3722 Whipple Ave NW
Canton, OH 44718-2934

Mailing address

3722 Whipple Ave NW
Canton, OH 44718-2934
Phone (330) 492-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109000990 OH Practitioner - Mental Health Counselor 4981055522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Barbara Fordyce and Associates, LLCGroup PAC ID 4486966538, 4 clinicians

Practice addresses (Care Compare)

4319 Hills and Dales Rd NW
Canton, OH 44708-1663
Phone (330) 492-2006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
E144OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia D. Rudick, PH.D, LPCC-S & Co., LLC Mental Health Current Accepting new patients
Barbara Fordyce & Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

3722 Whipple Ave NW
Canton, OH 44718
Phone (330) 324-7785

4319 Hills and Dales Rd NW
Canton, OH 44708
Phone (330) 478-6333

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144335647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3722 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182934",
            "telephone_number": "330-492-2006",
            "fax_number": "330-492-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182934",
            "telephone_number": "330-492-2006",
            "fax_number": "330-492-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDICK",
        "first_name": "CYNTHIA",
        "middle_name": "DIANE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.