Provider Demographics
NPI:1003939125
Name:KIESSLING, ROY (MSW)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:KIESSLING
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6554 MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-3141
Mailing Address - Country:US
Mailing Address - Phone:513-561-2068
Mailing Address - Fax:513-561-3637
Practice Address - Street 1:11223 CORNELL PARK DR
Practice Address - Street 2:#402
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-1835
Practice Address - Country:US
Practice Address - Phone:513-324-3637
Practice Address - Fax:513-561-3637
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI045951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical