IndividualActive
Autumn Wagoner, LISW
NPI 1962875245 · Clinical Social Worker · Canton, OH
Provider details
- NPI number
- 1962875245
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LISW
- Sex
- Female
- Sole proprietor
- No
- License
- I.2506755 (OH)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4641 Fulton Dr Nw
Canton, OH 44718-2384
Phone: (330) 433-6075
Street-level locationGet directions
Mailing address
4641 Fulton Dr Nw
Canton, OH 44718-2384
Additional practice locations (3)
- 405 S Linden AveAlliance, OH 44601-3035Phone: (330) 433-6075
- 1801 Schneider St NeCanton, OH 44721-3349Phone: (330) 470-4061
- 919 2nd St NeCanton, OH 44704-1132Phone: (330) 454-7917Fax: (330) 454-7917
Registry dates
- Enumerated
- 2015-11-09
- Last updated
- 2025-10-09
- Certified
- 2025-10-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.