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Organization
WELLNESS GROVE, LLC
Active
Organization
WELLNESS GROVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN SWIGER (CHIEF INFORMATION OFFICER)
(330) 915-2907
Entity
Organization
Contact information
Practice address
4522 FULTON DR NW, CANTON, OH 44718-2332
(330) 915-2907
(330) 915-2958
Mailing address
4522 FULTON DR NW, CANTON, OH 44718-2332
(330) 915-2907
(330) 915-2958
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0444569
—
OH
Enumeration date
04/07/2021
Last updated
10/26/2024
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