Active NPI
Emily E Indorf, LPCC
- Professional Counselor
- North Canton, OH
National Provider Identifier
1982113734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E1700331
- Practice address
- 1469 S Main St
North Canton, OH 44720-4245 - Phone
- (330) 499-3065
- Fax
- (330) 499-2497
- NPI assigned
- Sep 25, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E1700331 | OH | Primary |
Addresses
Primary practice location
1469 S Main St
North Canton, OH 44720-4245
Mailing address
1469 S Main St
North Canton, OH 44720-4245
Phone (330) 499-3065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E1700331 | Other | OH | STATE OF OHIO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1700331 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gentle Shepherd Counseling Center | Professional | Past | Accepting new patients |
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.
-
- Professional Counselor
- North Canton, OH
- NPI 1003076654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1982113734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1469 S MAIN ST",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447204245",
"telephone_number": "330-499-3065",
"fax_number": "330-499-2497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1469 S MAIN ST",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447204245",
"telephone_number": "330-499-3065",
"fax_number": "330-499-2497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INDORF",
"first_name": "EMILY",
"middle_name": "E",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-25",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E1700331",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF OHIO",
"identifier": "E1700331",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.