Active NPI
Erin Black, LPCC
- Mental Health Counselor
- Canton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E.2404722
- Practice address
- 4200 Munson St NW Ste a
Canton, OH 44718-2981 - Phone
- (330) 915-2907
- Fax
- (330) 915-2958
- NPI assigned
- Mar 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.2404722 | OH | |
| Mental Health Counselor | 101YM0800X | E.2404722 | OH | Primary |
| Counselor | 101Y00000X | E.2404722 | OH |
Addresses
Primary practice location
4200 Munson St NW Ste a
Canton, OH 44718-2981
Mailing address
4522 Fulton Dr NW
Canton, OH 44718-2332
Phone (330) 915-2907
Other practice location 1
4522 Fulton Dr NW
Canton, OH 44718-2332
Phone (330) 915-2907
Other practice location 2
5611 Hudson Dr Ste 400
Hudson, OH 44236-4452
Phone (330) 915-2907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0348524 | Medicaid | OH |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4200 Munson St NW
Suite a
Canton, OH 44718-2981
Phone (330) 915-2907
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.2404722 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness Grove LLC | Mental Health | Current | Accepting new patients |
| Wellness Grove, LLC | Counselor | Current | 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.
-
- Mental Health Counselor
- Canton, OH
- NPI 1043899859
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Canton, OH
- NPI 1124865654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768867200000",
"number": "1912465774",
"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": "4200 MUNSON ST NW STE A",
"city": "CANTON",
"state": "OH",
"postal_code": "447182981",
"telephone_number": "330-915-2907",
"fax_number": "330-915-2958"
}
],
"practiceLocations": [
{
"address_1": "4522 Fulton Dr NW",
"address_purpose": "LOCATION",
"city": "Canton",
"state": "OH",
"postal_code": "447182332",
"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": "330-915-2907",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLACK",
"first_name": "ERIN",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-11",
"last_updated": "2026-01-20",
"certification_date": "2026-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.2404722",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E.2404722",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "E.2404722",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0348524",
"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 Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.