Individual provider Active NPI

Bridget Ann McConnell, PCC

  • Mental Health Counselor
  • North Canton, OH
National Provider Identifier
1295554392
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E-0007210 Issued in OH
Practice address
1201 S Main St Ste 100
North Canton, OH 44720-4283
Phone
(330) 244-8795
Fax
(330) 244-8795
NPI assigned
Oct 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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 E-0007210 OH Primary

Addresses

Primary practice location

1201 S Main St Ste 100
North Canton, OH 44720-4283

Mailing address

6529 Culpepper St NW
Canton, OH 44718-4105
Phone (216) 849-6113

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
I20241206003147 OH Practitioner - Mental Health Counselor 1850827353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E-0007210OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Psychological & Counseling Centre LLC Mental Health CurrentSince Oct 1, 2024 Accepting new patients

Locations

4845 Fulton Dr NW
Ste 4
Canton, OH 44718
Phone (330) 244-8782

1201 S Main St
Ste 100
North Canton, OH 44720
Phone (330) 244-8782

Organizations & group practices 1

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": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1295554392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6529 CULPEPPER ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447184105",
            "telephone_number": "216-849-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST STE 100",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447204283",
            "telephone_number": "330-244-8795",
            "fax_number": "330-244-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "BRIDGET",
        "middle_name": "ANN",
        "credential": "PCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E-0007210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.