ANDREW GRANT PRENDERGAST
NPI 1104309335
Prevention Professional in Canton, OH

Q: What is Andrew Prendergast's NPI number?

The NPI number for Andrew Prendergast is 1104309335. It was assigned to this individual provider in the NPPES registry on September 13, 2018.

Q: What is Andrew Prendergast's specialty?

The primary specialty registered for this NPI is Prevention Professional with taxonomy code 405300000X.

Active since September 13, 2018

601 CLEVELAND AVE NW, CANTON, OH 44702(330) 455-0374(330) 453-6716 Get Directions Write a Review

NPPES record last updated: October 25, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 25, 2019, Sep 13, 2018 (2 updates tracked since 2018).

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About Andrew Grant Prendergast NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW GRANT PRENDERGAST (NPI 1104309335) is an individual prevention professional provider in Canton, Ohio, licensed in Ohio (OCPSA.161356) and active in the NPI registry since September 2018.

NPPES Registry Identity

NPI1104309335

Entity TypeIndividualMale

Primary Taxonomy405300000X

Provider Legal NameANDREW GRANT PRENDERGAST

Location Address601 CLEVELAND AVE NWCanton, OH 44702-1836

Mailing Address625 Cleveland Ave NwCanton, OH 44702-1805 · (330) 455-0374 · Fax (330) 453-6716

Phone(330) 455-0374

Fax(330) 453-6716

Sole ProprietorNo

Enumeration DateSeptember 13, 2018

Last NPPES UpdateOctober 25, 20192 updates tracked since enumeration

✔ NPI 1104309335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPrevention ProfessionalOther Service Providers

Taxonomy Code405300000X

License✔ Licensed in OH · OCPSA.161356

Definition

Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work.

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

601 CLEVELAND AVE NW, Canton, OH 44702

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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Community Health Worker