Individual provider Active NPI

Norman Diveley, LPCC

  • Professional Counselor
  • Canton, OH
National Provider Identifier
1790888576
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0004178 Issued in OH
Practice address
919 2ND St NE
Canton, OH 44704-1132
Phone
(330) 454-7917
NPI assigned
Sep 6, 2006
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Male
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X E0004178 OH Primary

Addresses

Primary practice location

919 2ND St NE
Canton, OH 44704-1132

Mailing address

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

Other practice location 1

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

Other practice location 2

3445 S Main St
Coventry Township, OH 44319-3028
Phone (330) 644-4095 ext. 302

Other identifiers 1

IdentifierTypeStateIssuer
0323346MedicaidOH

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
I20241203000408 OH Practitioner - Mental Health Counselor 5597290312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E0004178OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Behavioral Health CurrentSince Sep 19, 2024 Accepting new patients
Child and Adolescent Behavioral Health Past Accepting new patients

Locations

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

1801 Schneider St NE
Canton, OH 44721
Phone (330) 454-7917

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

919 2nd St NE
Canton, OH 44704
Phone (330) 454-7917

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1790888576",
    "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": "919 2ND ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447041132",
            "telephone_number": "330-454-7917"
        }
    ],
    "practiceLocations": [
        {
            "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"
        },
        {
            "address_1": "3445 S Main St",
            "address_purpose": "LOCATION",
            "city": "Coventry Township",
            "state": "OH",
            "postal_code": "443193028",
            "country_code": "US",
            "telephone_number": "330-644-4095 x302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIVELEY",
        "first_name": "NORMAN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0004178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0323346",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.