NPIMap

Organization Active NPI

Child and Adolescent Behavioral Health

  • Community/Behavioral Health Agency
  • Canton, OH
National Provider Identifier
1831172576
Registry record updated Aug 21, 2025
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
Fax
(330) 494-0299
NPI assigned
Nov 28, 2005
Last updated
Aug 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Voluntary or Charitable Agency 251V00000X

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

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

Other practice location 2

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

Other practice location 3

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

Other identifiers 2

IdentifierTypeStateIssuer
2846844MedicaidOH
3570MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161201000343 OH Part B Supplier - Clinic/Group Practice 2264712694 Receives reassigned benefits from 22 practitioners
Practice locations: Alliance, OH; Canton, OH

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

1207 W State St
Alliance, OH 44601
Phone (330) 451-1310

Practitioners & affiliated clinicians

Practitioners 54

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 54

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1831172576",
    "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": "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": "919 2nd St NE",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447041132",
            "country_code": "US",
            "telephone_number": "330-454-7917",
            "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": "2005-11-28",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "SHAHAN",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "HR ADMIN ASSISTANT/CREDENTIALING",
        "authorized_official_telephone_number": "330-433-6075"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846844",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3570",
            "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 Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.