Provider Demographics
NPI:1053307207
Name:KAERICHER, DIANNE (LISW)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:KAERICHER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MR
Other - First Name:DIANNE
Other - Middle Name:
Other - Last Name:NYITRAY-KAERICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8440
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-0440
Mailing Address - Country:US
Mailing Address - Phone:419-885-0200
Mailing Address - Fax:419-885-0203
Practice Address - Street 1:6832 CONVENT BLVD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-4805
Practice Address - Country:US
Practice Address - Phone:419-882-4529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0004496104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
S68696Medicare UPIN
OHSW19882Medicare ID - Type Unspecified
OHSW19883Medicare PIN