Provider Demographics
NPI:1063847119
Name:GEBHARDT, ANN MARIE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:GEBHARDT
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8256 E MARKET ST STE 115
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2300
Mailing Address - Country:US
Mailing Address - Phone:330-469-2312
Mailing Address - Fax:
Practice Address - Street 1:8256 E MARKET ST STE 115
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2300
Practice Address - Country:US
Practice Address - Phone:330-469-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1200170101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH12402Medicaid