Provider Demographics
NPI:1952886418
Name:PYLE, JARROD BRANDON (LICDC, LPC)
Entity type:Individual
Prefix:
First Name:JARROD
Middle Name:BRANDON
Last Name:PYLE
Suffix:
Gender:M
Credentials:LICDC, LPC
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 1:4429 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2867
Practice Address - Country:US
Practice Address - Phone:330-778-2919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.162722101YA0400X
OHC.2406540101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLICDC.162184OtherLICENSED INDEPENDENT CHEMICAL DEPENDENCY COUNSELOR
OHC.2406540OtherLICENSED PROFESSIONAL COUNSELOR