Organization Active NPI

Child and Adolescent Behavioral Health

  • Community/Behavioral Health Agency
  • Canton, OH
National Provider Identifier
1477787935
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHILD AND ADOLESCENT BEHAVIORAL HEALTH
Practice address
4641 Fulton Dr NW
Canton, OH 44718-2384
Phone
(330) 433-6075
NPI assigned
May 12, 2009
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Mr. Chris Warsinksy, LSW
Title
Director of Outpatient Services
Phone
(330) 433-6075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

4641 Fulton Dr NW
Canton, OH 44718-2384

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0290822MedicaidOH

National Provider Directory

National Provider Directory

Locations

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1477787935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-433-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182384",
            "telephone_number": "330-433-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND ADOLESCENT BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "WARSINKSY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT SERVICES",
        "authorized_official_telephone_number": "330-433-6075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290822",
            "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 May 12, 2009; 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.