Carolyn Denise Gentry
Peer Specialist in Youngstown, OH. Individual provider (NPI-1).
NPI number1801385752
StatusActive
Last updated in NPPESJan 27, 2021
Details
- NPI
- 1801385752
- Entity type
- Individual (NPI-1)
- Name
- Carolyn Denise Gentry
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 7, 2018
- Certification date
- Jan 27, 2021
- Last updated
- Jan 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | OH | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CDCA.165128 | OH |
Practice location
2151 Rush BlvdYoungstown, OH 44507-1535
Phone 330-744-1181
Mailing address
146 Sayers AveNiles, OH 44446-1725
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