Provider Demographics
NPI:1235482894
Name:KAISER, JARED (LPCC-S)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:KAISER
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1879 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8602
Mailing Address - Country:US
Mailing Address - Phone:513-695-2726
Mailing Address - Fax:
Practice Address - Street 1:4936 OLD IRWIN SIMPSON RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9751
Practice Address - Country:US
Practice Address - Phone:513-649-7458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1100451101Y00000X
OHE.1100451-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor