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Carolyn Denise Gentry
Peer Specialist in Youngstown, Ohio
NPI 1801385752

Carolyn Denise Gentry is a Peer Specialist based in Niles, OH. Carolyn Denise Gentry practices in Youngstown, OH. The NPI Number for Carolyn Denise Gentry is 1801385752 and holds a License No. CDCA.165128 (Ohio).

The current practice location address for Carolyn Denise Gentry is 2151 Rush Blvd, Youngstown, OH and can be reached out via phone at 330-744-1181.

Location: 2151 Rush Blvd, Youngstown, OH, 44446-1725
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1801385752
Provider Name
Carolyn Denise Gentry
Credential
Provider Entity Type
Individual
Gender
Female
Address
2151 Rush Blvd, Youngstown, OH, 44446-1725
Phone Number
330-744-1181
Fax Number
Provider Enumeration Date
05/07/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0282408 05 OH
institution
Provider Business Practice Location Address Details
Address
2151 Rush Blvd
City
Youngstown
State
Ohio
Zip
44507-1535
Phone Number
330-744-1181
Fax Number
person
Provider Business Mailing Address Details
Address
2151 Rush Blvd
City
Youngstown
State
Ohio
Zip
44507-1535
Phone Number
330-744-1181
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
(Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
CDCA.165128 (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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