Provider Demographics
NPI:1356492631
Name:KESSLER, LINDA A (MSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:KESSLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 GYPSY LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1314
Mailing Address - Country:US
Mailing Address - Phone:330-746-7929
Mailing Address - Fax:330-746-7939
Practice Address - Street 1:940 WINDHAM CT
Practice Address - Street 2:SUITE 6
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5060
Practice Address - Country:US
Practice Address - Phone:330-726-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00026611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKESW22301Medicare ID - Type Unspecified