Provider Demographics
NPI:1245757004
Name:WIRTH, KATHRYN D
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:D
Last Name:WIRTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMMUNITY SUPPORT SERVICES, INC.
Mailing Address - Street 2:150 CROSS ST
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1026
Mailing Address - Country:US
Mailing Address - Phone:330-253-9388
Mailing Address - Fax:330-376-6726
Practice Address - Street 1:COMMUNITY SUPPORT SERVICES, INC.
Practice Address - Street 2:150 CROSS ST
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1026
Practice Address - Country:US
Practice Address - Phone:330-253-9388
Practice Address - Fax:330-376-6726
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)