Provider Demographics
NPI:1346936523
Name:KAYCO THERAPY, LLC
Entity Type:Organization
Organization Name:KAYCO THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:CHARLOTTE
Authorized Official - Last Name:O'NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW, ACHT
Authorized Official - Phone:419-707-9792
Mailing Address - Street 1:12331 WATERSTONE LN APT 723
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3046
Mailing Address - Country:US
Mailing Address - Phone:419-707-9792
Mailing Address - Fax:
Practice Address - Street 1:2735 N HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1846
Practice Address - Country:US
Practice Address - Phone:419-707-9792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty