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WELLNESS GROVE LLC
NPI 1124865654
Clinic/Center - Mental Health (Including Community Mental Health Center) in Canton, OH

Active since July 11, 2024
4522 FULTON DR NW, CANTON, OH 44718(330) 915-2907(330) 915-2958 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 20, 2026, Mar 28, 2025, Aug 23, 2024 and 1 more (4 updates tracked since 2024).

About Wellness Grove Llc NPPES

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

WELLNESS GROVE LLC (NPI 1124865654), doing business as Wellness Grove, is a healthcare organization registered as a mental health (including community mental health center) in Canton, Ohio and active in the NPI registry since July 2024. The organization maintains 2 additional practice locations and lists Shaun Swiger, Chief Information Officer, as its authorized official.

NPPES Registry Identity

NPI1124865654
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameWELLNESS GROVE LLC
Location Address4522 FULTON DR NWCanton, OH 44718-2332
Mailing Address4522 Fulton Dr NwCanton, OH 44718-2332 · (330) 915-2907
Phone(330) 915-2907
Fax(330) 915-2958
Organization SubpartNo
Authorized OfficialShaun SwigerChief Information Officer · (330) 915-2907
Enumeration DateJuly 11, 2024
Last NPPES UpdateJanuary 20, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2026
✔ NPI 1124865654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 13

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedSocial WorkerTaxonomy 104100000X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedMarriage & Family TherapistTaxonomy 106H00000X
Also ListedArt TherapistTaxonomy 221700000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4522 FULTON DR NW, Canton, OH 44718
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Other Names 1

Doing Business AsWellness Grove

Secondary Practice Locations 2

Location 15611 Hudson Dr Ste 400Hudson, OH 44236-4452 · Phone (330) 915-2907 · Fax (330) 915-2958
Location 24200 Munson St NW Ste ACanton, OH 44718-2981 · Phone (330) 915-2907 · Fax (330) 915-2958

Other Identifiers 1

Medicaid0085951OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wellness Grove Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateOhioEnrollment IDO20211111000586Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

36

Medicare enrollment records show 36 clinicians reassign Medicare billing to Wellness Grove LLC, which bills Medicare for the services they deliver. Of these, 24 practice at this address and 31 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 2

Mental Health Counselor32
Clinical Social Worker4

Nearest to this location (20)

See all 36
Gina Bowers, LISW-S
Clinical Social Worker
NPI 1942750666
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Jessica Budyka, LPCC
Mental Health Counselor
NPI 1679920623
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOSSame address
Matthew Campbell, LPCC-S
Mental Health Counselor
NPI 1801387915
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
David Carroll, LPCC-S
Mental Health Counselor
NPI 1992353718
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Rebecca Chajkowski, LPCC-S
Mental Health Counselor
NPI 1164915039
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Thomas Deiotte, LPCC
Mental Health Counselor
NPI 1801386263
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Pamela Ebert, LPCC-S
Mental Health Counselor
NPI 1467711580
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Lynn Edwards, LPCC-S
Mental Health Counselor
NPI 1629167564
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Anna Ellenson, LPCC
Mental Health Counselor
NPI 1679268452
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOSSame address
Brittany Franklin, LPCC-S
Mental Health Counselor
NPI 1053823633
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Larissa Haring, LPCC
Mental Health Counselor
NPI 1174868129
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOSSame address
Jessica Headley, LPCC-S
Mental Health Counselor
NPI 1316450562
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Emily Johnson, LISW
Clinical Social Worker
NPI 1427734425
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Michael Luthy, LPCC
Mental Health Counselor
NPI 1063876522
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOSSame address
Sara Newman, LISW-S
Clinical Social Worker
NPI 1497953657
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Joshua Prince, LPCC
Mental Health Counselor
NPI 1962025718
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Gregory Southard, IMFT-S, LPCC-S
Mental Health Counselor
NPI 1588183453
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOSSame address
Jessica Stephens, LPCC
Mental Health Counselor
NPI 1700283801
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Rachel Tassile, LISW
Clinical Social Worker
NPI 1134617988
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
Lauren Wallace, LPCC
Mental Health Counselor
NPI 1316417793
4522 FULTON DR NW
Canton, OH 44718
(330) 915-2907
✔ PECOS✔ Accepts MedicareSame address
See all 36 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellness Grove LLC's NPI number?

The NPI number for Wellness Grove LLC is 1124865654. It was assigned to this organization in the NPPES registry on July 11, 2024. The provider is doing business as Wellness Grove.

Where is Wellness Grove LLC located?

Wellness Grove LLC is located at 4522 Fulton Dr NW, Canton, OH 44718. The listed phone number is (330) 915-2907.

What is Wellness Grove LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Wellness Grove LLC enrolled in Medicare?

Yes. Wellness Grove LLC is registered in the Medicare PECOS enrollment system.

When is Wellness Grove LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Ohio, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Wellness Grove LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 36 clinicians in 2 Medicare specialties reassign their Medicare billing to Wellness Grove LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (32) and Clinical Social Worker (4). Of these, 24 practice at this address and 31 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Wellness Grove LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Molina Healthcare list Wellness Grove LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wellness Grove LLC was last updated on January 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.