Provider Demographics
NPI:1952886418
Name:PYLE, JARROD BRANDON (LCDC III)
Entity Type:Individual
Prefix:
First Name:JARROD
Middle Name:BRANDON
Last Name:PYLE
Suffix:
Gender:M
Credentials:LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 SUFFOLK ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-9707
Mailing Address - Country:US
Mailing Address - Phone:330-356-4326
Mailing Address - Fax:
Practice Address - Street 1:24 N HIGH ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1926
Practice Address - Country:US
Practice Address - Phone:330-657-8566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.166091101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLCDC.162184OtherOHIO CHEMICAL DEPENDENCY PROFESSIONALS BOARD