Provider Demographics
NPI:1114023033
Name:ARMBRUSTER, KELLEY M (LISW)
Entity Type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:M
Last Name:ARMBRUSTER
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 1:5451 PRESCOTT CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-5633
Mailing Address - Country:US
Mailing Address - Phone:513-336-0614
Mailing Address - Fax:513-770-0888
Practice Address - Street 1:7577 CENTRAL PARKE BLVD STE 313
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6822
Practice Address - Country:US
Practice Address - Phone:513-770-0800
Practice Address - Fax:513-770-0888
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00056031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical