Provider Demographics
NPI:1215212857
Name:VOGEL, KIMBERLY K (LISW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:K
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 S EDWIN C MOSES BLVD
Mailing Address - Street 2:SAMARITAN BEHAVIOR HEALTH, INC., 4TH FLOOR NW BLDG
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3424
Mailing Address - Country:US
Mailing Address - Phone:937-734-8333
Mailing Address - Fax:937-734-4343
Practice Address - Street 1:601 S EDWIN C MOSES BLVD
Practice Address - Street 2:SAMARITAN BEHAVIOR HEALTH, INC. 1ST FLOOR NW BLDG
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:937-734-8333
Practice Address - Fax:937-734-4343
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHI0701011SUPV1041C0700X
OHI 07010111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical