1942292156 NPI number — PAULA J KLUSMAN LPCC

Table of content: PAULA J KLUSMAN LPCC (NPI 1942292156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942292156 NPI number — PAULA J KLUSMAN LPCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLUSMAN
Provider First Name:
PAULA
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942292156
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 VICTORY PKWY
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45206-2839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-221-2330
Provider Business Mailing Address Fax Number:
513-221-8954

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2330 VICTORY PKWY
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45206-2839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-221-2330
Provider Business Practice Location Address Fax Number:
513-221-8954
Provider Enumeration Date:
08/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  E-0002822 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000219299 . This is a "ANTHEM BC/BS OF OH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 326748 . This is a "MANAGED HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2842839 . This is a "MEDICAID - FOR MED HMO ONLY" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 471294000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier . This identifiers is of the category "OTHER".




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