Provider Demographics
NPI:1003908716
Name:KEMPEL, MARTYNE C (LISW)
Entity Type:Individual
Prefix:
First Name:MARTYNE
Middle Name:C
Last Name:KEMPEL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E MILLTOWN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1246
Mailing Address - Country:US
Mailing Address - Phone:330-345-3418
Mailing Address - Fax:
Practice Address - Street 1:210 E MILLTOWN RD
Practice Address - Street 2:SUITE B
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1246
Practice Address - Country:US
Practice Address - Phone:330-345-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH26581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW01742Medicare PIN