Active NPI
Alexandra L Gauntner, LPCC
- Professional Counselor
- Canton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E2102090
- Practice address
- 624 Market Ave N
Canton, OH 44702-1017 - Phone
- (330) 493-4553
- Fax
- (330) 493-3761
- NPI assigned
- Jun 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E2102090 | OH | Primary |
Addresses
Primary practice location
624 Market Ave N
Canton, OH 44702-1017
Mailing address
624 Market Ave N
Canton, OH 44702-1017
Phone (330) 493-4553
Other names 1
- Alexandra L Shultz
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
340 S Broadway St
Akron, OH 44308-1529
Phone (330) 253-3100
792 Graham Rd
Cuyahoga Falls, OH 44221-1000
Phone (330) 928-2324
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E2102090 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Portage Path Community Mental Health Center | Current | Accepting new patients | |
| Portage Path Behavioral Health | Past | Accepting new patients |
Locations
340 S Broadway St
Akron, OH 44308
Phone (330) 253-3100
105 5th St SE
Ste 6
Barberton, OH 44203
Phone (330) 745-0081
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.
-
dba Portage Path Behavioral health
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Akron, OH
- NPI 1225087802
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Akron, OH
- NPI 1114492147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1144715962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 MARKET AVE N",
"city": "CANTON",
"state": "OH",
"postal_code": "447021017",
"telephone_number": "330-493-4553",
"fax_number": "330-493-3761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 MARKET AVE N",
"city": "CANTON",
"state": "OH",
"postal_code": "447021017",
"telephone_number": "330-493-4553",
"fax_number": "330-493-3761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUNTNER",
"first_name": "ALEXANDRA",
"middle_name": "L",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-25",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E2102090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALEXANDRA",
"last_name": "SHULTZ",
"middle_name": "L",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}
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 Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.