Provider Demographics
NPI:1295843928
Name:WOZNIAK, KATHRYN C (LPCC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:C
Last Name:WOZNIAK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 LOGAN WAY
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-3311
Mailing Address - Country:US
Mailing Address - Phone:330-259-3664
Mailing Address - Fax:330-259-3665
Practice Address - Street 1:4505 LOGAN WAY
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-3311
Practice Address - Country:US
Practice Address - Phone:330-259-3664
Practice Address - Fax:330-259-3665
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE263101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH302326882010OtherMEDICAL MUTUAL
OH000000205359OtherANTHEM
OH2032571Medicaid
OH9316671Medicare ID - Type UnspecifiedMEDICARE PART B