Individual
PAYTON ASHLEY SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COUNSELOR IN TRAINEE
Contact information
Practice address
16 EVANS AVE, AUSTINTOWN, OH 44515-1621
(330) 330-8655
(330) 330-8657
Mailing address
725 BOARDMAN CANFIELD RD STE L1, BOARDMAN, OH 44512-4370
(330) 330-8655
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.2507246
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.187159
OH
Other
Enumeration date
07/13/2024
Last updated
06/18/2025
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