Individual provider Active NPI

Jodi Lee Fellers, M.A.

  • Professional Counselor
  • Canton, OH
National Provider Identifier
1467773077
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0005777 Issued in OH
Practice address
1801 Schneider St NE
Door 6
Canton, OH 44721-3349
Phone
(330) 470-4061
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0005777 OH Primary

Addresses

Primary practice location

1801 Schneider St NE
Door 6
Canton, OH 44721-3349

Mailing address

12018 Snode St NE
Alliance, OH 44601-9665
Phone (330) 821-2648

Other practice location 1

405 S Linden Ave
Alliance, OH 44601-3035
Phone (330) 433-6075

Other practice location 2

4641 Fulton Dr NW
Canton, OH 44718-2384
Phone (330) 433-6075

Other identifiers 1

IdentifierTypeStateIssuer
0265828MedicaidOH

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0005777OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Behavioral Health Past Accepting new patients
Child and Adolescent Behavioral Health PastSince Aug 5, 2024 Accepting new patients

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1467773077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12018 SNODE ST NE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446019665",
            "telephone_number": "330-821-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SCHNEIDER ST NE",
            "address_2": "DOOR 6",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447213349",
            "telephone_number": "330-470-4061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 S Linden Ave",
            "address_purpose": "LOCATION",
            "city": "Alliance",
            "state": "OH",
            "postal_code": "446013035",
            "country_code": "US",
            "telephone_number": "330-433-6075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4641 Fulton Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182384",
            "country_code": "US",
            "telephone_number": "330-433-6075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELLERS",
        "first_name": "JODI",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "0005777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265828",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.