Individual provider Active NPI

David J Zavasky, PC

  • Professional Counselor
  • Canton, OH
National Provider Identifier
1861781676
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
900624 Issued in OH
Practice address
625 Cleveland Ave NW
Canton, OH 44702-1805
Phone
(330) 455-0374
Fax
(330) 455-2101
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 900624 OH Primary

Addresses

Primary practice location

625 Cleveland Ave NW
Canton, OH 44702-1805

Mailing address

2906 Treeside St NW
Apt a
Canton, OH 44709-1957
Phone (330) 478-4543

Other identifiers 1

IdentifierTypeStateIssuer
2098331MedicaidOH

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
I20240702004423 OH Practitioner - Mental Health Counselor 0345784245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glovan, Pollak and Associates LLCGroup PAC ID 9032337308, 9 clinicians

Practice addresses (Care Compare)

8224 Mentor Ave
Suite 208
Mentor, OH 44060-5743
Phone (440) 392-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
900624OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Glovan Pollak and Associates LLC CurrentSince Jun 3, 2024 Accepting new patients

Locations

8224 Mentor Ave
Ste 208
Mentor, OH 44060
Phone (440) 392-2222

Organizations & group practices 1

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": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1861781676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 TREESIDE ST NW",
            "address_2": "APT A",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447091957",
            "telephone_number": "330-478-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-455-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVASKY",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "900624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2098331",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.