MOHICAN YOUTH ACADEMY NPI 1063926616

NPI Information

  • NPI: 1063926616
  • Provider Name: MOHICAN YOUTH ACADEMY
  • Classification: Psychiatry & Neurology - 2084P0005X
  • Specialization: Neurodevelopmental Disabilities
  • Entity Type: Organization
  • Address: 1012 ODNR MOHICAN 51
    PERRYSVILLE, OH
    ZIP 44864
  • Phone: (419) 994-0300

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NPI Details

MOHICAN YOUTH ACADEMY is a neurodevelopmental disabilities psychiatry neurology in Perrysville, OH. The provider is a neurologist who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. MOHICAN YOUTH ACADEMY NPI is 1063926616. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1012 ODNR MOHICAN 51
PERRYSVILLE, OH
ZIP 44864-407
Phone: (419) 994-0300

The provider's authorized official is Wendy Bruno .
The authorized official title is Credentialing and has the following contact phone number (614) 556-4616.

The enumeration date for this NPI number is 11/18/2017 and was last updated on 11/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0005XPsychiatry & NeurologyNeurodevelopmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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