GREGORY SOUTHARD (IMFT-S, LPCC-S) – Mental Health Counselor, NPI 1588183453

GREGORY SOUTHARD (IMFT-S, LPCC-S) is a healthcare provider. based in Canton, Ohio. specializing in Mental Health Counselor. They hold the professional credentials IMFT-S, LPCC-S. They hold a License No. F.2100158-SUPV (OH). The NPI Number for GREGORY SOUTHARD (IMFT-S, LPCC-S) is 1588183453

Main info

Male
Sole Proprietor
Name
GREGORY SOUTHARD (IMFT-S, LPCC-S)
NPI
1588183453
Phone
(330) 915-2907
Address
4200 Munson St NW Ste A
Enumeration Date
12 September 2017
Last Update Date
29 April 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness85
Years active:8State licenses:3Digital endpointsOther names

Provider Addresses for GREGORY SOUTHARD (IMFT-S, LPCC-S)

  • 4200 Munson St NW Ste A

    Canton, OH 447182981

    Phone: (330) 915-2907

    Fax: (330) 915-2958

    Type: Location

  • 960 Graham Rd. Unit 3

    Cuyahoga Falls, OH 44221

    Phone: (330) 606-9262

    Type: Location

  • 5611 Hudson Dr Ste 400

    Hudson, OH 442364452

    Phone: (330) 915-2907

    Fax: (330) 915-2958

    Type: Location

  • 524, West Park Avenue, Downtown Barberton, Barberton, Summit County, Ohio, 44203, United States

    BARBERTON, OH 442032580

    Phone:

    Type: Mailing

  • 18 N Forge St

    Akron, OH 443041317

    Phone: (330) 762-0591

    Fax: (330) 762-2242

    Type: Location

  • 524 W Park Ave

    Barberton, OH 442032580

    Phone: (330) 753-1096

    Type: Location

  • 4522 FULTON DR NW

    CANTON, OH 447182332

    Phone: (330) 915-2907

    Fax: (330) 915-2958

    Type: Mailing

  • 960 GRAHAM RD., UNIT 3

    CUYAHOGA FALLS, OH 44221

    Phone:

    Type: Mailing

  • 960 GRAHAM RD. UNIT 3

    CUYAHOGA FALLS, OH 44221

    Phone: (330) 606-9262

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240112001455IMental Health CounselorOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44718)

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Reviews

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Frequently asked questions

How do payers reference GREGORY SOUTHARD (IMFT-S, LPCC-S)?
For GREGORY SOUTHARD (IMFT-S, LPCC-S), use NPI 1588183453 as the unique 10-digit identifier.
Would GREGORY SOUTHARD (IMFT-S, LPCC-S) appear as active to a payer?
You can treat GREGORY SOUTHARD (IMFT-S, LPCC-S) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for GREGORY SOUTHARD (IMFT-S, LPCC-S)?
At a glance, GREGORY SOUTHARD (IMFT-S, LPCC-S) is tied to Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where in Ohio is GREGORY SOUTHARD (IMFT-S, LPCC-S) registered?
Use Canton, Ohio as the headline location for GREGORY SOUTHARD (IMFT-S, LPCC-S) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.