Provider Demographics
NPI:1114200573
Name:KATSAROS, ASHLEY (LISW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KATSAROS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:LONGWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:434 EASTLAND RD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1217
Mailing Address - Country:US
Mailing Address - Phone:440-260-8327
Mailing Address - Fax:
Practice Address - Street 1:3500 CARNEGIE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2641
Practice Address - Country:US
Practice Address - Phone:440-260-8900
Practice Address - Fax:440-260-8576
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1450831-SUPV1041C0700X
OH09009211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical