Provider Demographics
NPI:1053442822
Name:YODER, KERSTIN MARIE (MSSA, LISW)
Entity Type:Individual
Prefix:MRS
First Name:KERSTIN
Middle Name:MARIE
Last Name:YODER
Suffix:
Gender:F
Credentials:MSSA, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11052 MAGDALA DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44130-1544
Mailing Address - Country:US
Mailing Address - Phone:440-781-7609
Mailing Address - Fax:
Practice Address - Street 1:11890 FAIRHILL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1053
Practice Address - Country:US
Practice Address - Phone:216-791-8000
Practice Address - Fax:216-373-2020
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 05000411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical