Kristen M Kotheimer, MSW, LISW-S | |
520 Youngstown Poland Rd, Struthers, OH 44471-1103 | |
(330) 318-3078 | |
(234) 855-1072 |
Full Name | Kristen M Kotheimer |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 520 Youngstown Poland Rd, Struthers, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245766062 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | I.2002411-SUPV (Ohio) | Primary |
1041C0700X | Social Worker - Clinical | S.1302238 (Ohio) | Secondary |
Entity Name | Psy-care, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396705349 PECOS PAC ID: 9335136795 Enrollment ID: O20040428000034 |
Mailing Address | Practice Location Address |
---|---|
Kristen M Kotheimer, MSW, LISW-S 2980 Belmont Ave, Youngstown, OH 44505-1834 Ph: (330) 759-0276 | Kristen M Kotheimer, MSW, LISW-S 520 Youngstown Poland Rd, Struthers, OH 44471-1103 Ph: (330) 318-3078 |
Deonna Lampley, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Youngstown Poland Rd, Struthers, OH 44471 Phone: 330-318-3078 Fax: 330-318-3078 | |
Gretchen Emch, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Youngstown Poland Rd, Struthers, OH 44471 Phone: 330-318-3078 Fax: 330-318-3078 | |
Gary Jennings, LISW-S Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Youngstown Poland Rd, Struthers, OH 44471 Phone: 330-318-3078 | |
Brian Hudzik, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Youngstown Poland Rd, Struthers, OH 44471 Phone: 330-881-6936 | |
Kacie Householder, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 520 Youngstown Poland Rd, Struthers, OH 44471 Phone: 330-318-3078 | |
Kara Mistovich, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Youngstown Poland Rd, Struthers, OH 44471 Phone: 330-318-3078 Fax: 330-318-3078 |