Provider Demographics
NPI:1326122656
Name:BRELSFORD, KANDI K (MSW)
Entity Type:Individual
Prefix:MS
First Name:KANDI
Middle Name:K
Last Name:BRELSFORD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:K
Other - Last Name:BRELSFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LISW-S
Mailing Address - Street 1:601 S EDWIN C MOSES BLVD, 4TH FLOOR NW BLDG
Mailing Address - Street 2:SAMARITAN BEHAVIORAL HEALTH INC
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 BEHAVIORAL HEALTH, INC.,
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:513-984-1800
Practice Address - Fax:513-984-4909
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI5281041C0700X
OHI.0000528-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical