Individual provider Active NPI

Jeremy Alan Guess

  • Mental Health Counselor
  • Canton, OH
National Provider Identifier
1306529375
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2305073-TRNE Issued in OH
Practice address
4522 Fulton Dr NW
Canton, OH 44718-2332
Phone
(330) 915-2907
NPI assigned
Aug 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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 C.2305073-TRNE OH Primary

Addresses

Primary practice location

4522 Fulton Dr NW
Canton, OH 44718-2332

Mailing address

4200 Munson St NW Ste a
Canton, OH 44718-2981
Phone (330) 915-2907

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
I20260424003314 OH Practitioner - Mental Health Counselor 2961979109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

900 Mull Ave
Akron, OH 44313-7597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2305073-TRNEOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Grove, LLC Mental Health CurrentSince Aug 13, 2023 Accepting new patients
Wellness Grove LLC Mental Health CurrentSince Jul 21, 2024 Accepting new patients

Locations

4200 Munson St NW
Ste A
Canton, OH 44718
Phone (330) 915-2907

4522 Fulton Dr NW
Canton, OH 44718
Phone (330) 915-2907

Organizations & group practices 3

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1306529375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 MUNSON ST NW STE A",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182981",
            "telephone_number": "330-915-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4522 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182332",
            "telephone_number": "330-915-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUESS",
        "first_name": "JEREMY",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2305073-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.