1861886285 NPI number — MS. VICTORIA LYN KAESLER MSW, LSW

Table of content: MS. VICTORIA LYN KAESLER MSW, LSW (NPI 1861886285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861886285 NPI number — MS. VICTORIA LYN KAESLER MSW, LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAESLER
Provider First Name:
VICTORIA
Provider Middle Name:
LYN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LSW
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:
1861886285
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 W. STANFIELD ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-339-5100
Provider Business Mailing Address Fax Number:
937-339-3256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 SOUTH TIPPECANOE DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIPP CITY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-667-8444
Provider Business Practice Location Address Fax Number:
937-667-6886
Provider Enumeration Date:
03/24/2015

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: 104100000X , with the licence number:  S18500 , 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)





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