Individual provider Active NPI

Erin Divincenzo, LPCC-S

  • Mental Health Counselor
  • Hudson, OH
National Provider Identifier
1447506613
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.1100357-SUPV Issued in OH
Practice address
5611 Hudson Dr Ste 400
Hudson, OH 44236-4452
Phone
(330) 915-2907
Fax
(330) 915-2958
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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.1100357-SUPV OH Primary

Addresses

Primary practice location

5611 Hudson Dr Ste 400
Hudson, OH 44236-4452

Mailing address

4522 Fulton Dr NW
Canton, OH 44718-2332
Phone (330) 915-2907

Other practice location 1

4522 Fulton Dr NW
Canton, OH 44718-2332
Phone (330) 915-2907

Other practice location 2

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

Other names 1

  • Erin Fittipaldi Former name

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4522 Fulton Rd
Canton, OH 44718

4522 Fulton Rd
Canton, OH 44718-2332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1100357OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Grove LLC Mental Health CurrentSince Jul 8, 2026 Accepting new patients
Wellness Grove, LLC Mental Health CurrentSince Jul 8, 2026 Accepting new patients

Locations

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

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

5611 Hudson Dr
Ste 400
Hudson, OH 44236
Phone (330) 915-2907

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1447506613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182332",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5611 HUDSON DR STE 400",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364452",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4522 Fulton Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182332",
            "country_code": "US",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4200 Munson St NW Ste A",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182981",
            "country_code": "US",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIVINCENZO",
        "first_name": "ERIN",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1100357-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "FITTIPALDI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hudson, OH

Sources for this page

Verify at the official NPI Registry.