Provider Demographics
NPI:1336848563
Name:YANCHEK, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:YANCHEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-9910
Mailing Address - Country:US
Mailing Address - Phone:330-376-9494
Mailing Address - Fax:
Practice Address - Street 1:580 GRANT ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-9910
Practice Address - Country:US
Practice Address - Phone:330-376-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204522-TRNE101YM0800X
OHC.2405697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health