Provider Demographics
NPI:1679878839
Name:NOWLIN, MARANDA E (LPCC-S)
Entity Type:Individual
Prefix:
First Name:MARANDA
Middle Name:E
Last Name:NOWLIN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:MARANDA
Other - Middle Name:E
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCC
Mailing Address - Street 1:2965 BEBINGTON ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4591
Mailing Address - Country:US
Mailing Address - Phone:330-826-1026
Mailing Address - Fax:
Practice Address - Street 1:2600 TUSCARAWAS ST W STE 340
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4694
Practice Address - Country:US
Practice Address - Phone:330-495-9607
Practice Address - Fax:330-495-9609
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1300020-SUPV101YP2500X
OHE1300020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty