NPIMap

Organization Active NPI

Child and Adolescent Behavioral Health

  • Addiction (Substance Use Disorder) Counselor
  • Canton, OH
National Provider Identifier
1821577131
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
CHILD AND ADOLESCENT BEHAVIORAL HEALTH
Practice address
4641 Fulton Dr NW
Canton, OH 44718-2384
Phone
(330) 433-6075
Fax
(330) 494-0299
NPI assigned
Aug 8, 2018
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Courtney Shahan
Title
HR Admin Asst/Credentialing
Phone
(330) 433-6075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 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 practice location 1

919 2nd St NE
Canton, OH 44704-1132
Phone (330) 454-7917 ext. 133

Other practice location 2

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

Other practice location 3

1801 Schneider St NE
Canton, OH 44721-3349
Phone (330) 470-4061

Other identifiers 1

IdentifierTypeStateIssuer
0309550MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Child and Adolescent Behavioral Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1801 Schneider St NE
Canton, OH 44721
Phone (330) 470-4061

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1821577131",
    "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",
            "fax_number": "330-494-0299"
        },
        {
            "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",
            "fax_number": "330-494-0299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "919 2nd St NE",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447041132",
            "country_code": "US",
            "telephone_number": "330-454-7917 x133",
            "fax_number": "330-452-8860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 S Linden Ave",
            "address_purpose": "LOCATION",
            "city": "Alliance",
            "state": "OH",
            "postal_code": "446013035",
            "country_code": "US",
            "telephone_number": "330-433-6075",
            "fax_number": "330-494-0299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 Schneider St NE",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447213349",
            "country_code": "US",
            "telephone_number": "330-470-4061",
            "fax_number": "330-470-4083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHILD AND ADOLESCENT BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-08",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "SHAHAN",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "HR ADMIN ASST/CREDENTIALING",
        "authorized_official_telephone_number": "330-433-6075"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0309550",
            "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 7, 2026; 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.