Individual provider Active NPI

Lynn Edwards, LPCC-S

  • Mental Health Counselor
  • Canton, OH
National Provider Identifier
1629167564
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.1400001-SUPV Issued in OH
Practice address
4522 Fulton Dr NW
Canton, OH 44718-2332
Phone
(330) 915-2907
Fax
(330) 915-2958
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3536-125 WI
Mental Health Counselor 101YM0800X E.1400001-SUPV OH Primary

Addresses

Primary practice location

4522 Fulton Dr NW
Canton, OH 44718-2332

Mailing address

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

Other practice location 1

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

Other practice location 2

5611 Hudson Dr Ste 400
Hudson, OH 44236-4452
Phone (330) 915-2907

Other identifiers 1

IdentifierTypeStateIssuer
0215653MedicaidOH

Other names 1

  • Lynn Edwards Miller Other name

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
I20250409002501 OH Practitioner - Mental Health Counselor 8224552435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellness Grove LLCGroup PAC ID 5092104109, 25 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3536-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Grove LLC Mental Health CurrentSince Mar 28, 2025 Accepting new patients
Wellness Grove, LLC Mental Health CurrentSince Feb 9, 2025 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

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1629167564",
    "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": "4522 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182332",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958"
        }
    ],
    "practiceLocations": [
        {
            "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"
        },
        {
            "address_1": "5611 Hudson Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "OH",
            "postal_code": "442364452",
            "country_code": "US",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LYNN",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3536-125",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1400001-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215653",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "EDWARDS MILLER",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.