Provider Demographics
NPI:1285773663
Name:DIGMAN, JOHN GLENN (LISW-S)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GLENN
Last Name:DIGMAN
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-2906
Mailing Address - Country:US
Mailing Address - Phone:330-655-6149
Mailing Address - Fax:
Practice Address - Street 1:1206 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1926
Practice Address - Country:US
Practice Address - Phone:330-433-2688
Practice Address - Fax:330-433-2689
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-11015311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH302920Medicare PIN