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Mrs. Michelle Lois Stackhouse, PEERSUPPORT
Peer Specialist in Canton, Ohio
NPI 1396229027

Michelle Lois Stackhouse is a Peer Specialist based in Canton, OH. Michelle Lois Stackhouse practices in Canton, OH and has the professional credentials of PEERSUPPORT. The NPI Number for Michelle Lois Stackhouse is 1396229027 and holds a License No. 00030 (Ohio).

The current practice location address for Michelle Lois Stackhouse is 5736 East Blvd Nw, Canton, OH and can be reached out via phone at 330-806-1953. You can also correspond with Michelle Lois Stackhouse through the mailing address at 5736 EAST BLVD NW, CANTON, OH - 44718-1655 (mailing address contact number: 330-806-1953).

Location: 5736 East Blvd Nw, Canton, OH, 44718-1655
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396229027
Provider Name
Michelle Lois Stackhouse
Credential
PEERSUPPORT
Provider Entity Type
Individual
Gender
Female
Address
5736 East Blvd Nw, Canton, OH, 44718-1655
Phone Number
330-806-1953
Fax Number
Provider Enumeration Date
09/19/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
34-1575839 01 OH ICAN, INC.
institution
Provider Business Practice Location Address Details
Address
5736 East Blvd Nw
City
Canton
State
Ohio
Zip
44718-1655
Phone Number
330-806-1953
Fax Number
person
Provider Business Mailing Address Details
Address
5736 East Blvd Nw
City
Canton
State
Ohio
Zip
44718-1655
Phone Number
330-806-1953
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
00030 (Ohio)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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