Provider Demographics
NPI:1003818519
Name:KASPER, RICHARD A (LISW)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:KASPER
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 VICTORY PKWY
Mailing Address - Street 2:STE 500
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2839
Mailing Address - Country:US
Mailing Address - Phone:513-221-2330
Mailing Address - Fax:513-221-8954
Practice Address - Street 1:2330 VICTORY PKWY
Practice Address - Street 2:STE 500
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2839
Practice Address - Country:US
Practice Address - Phone:513-221-2330
Practice Address - Fax:513-221-8954
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00076401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000222511OtherANTHEM BC/BS OF OHIO
197412000OtherMAGELLAN BEHAVIORAL HEALT
OH2842802OtherMEDICAID - MED HMO ONLY
OH2842802OtherMEDICAID - MED HMO ONLY