Provider Demographics
NPI:1508893108
Name:KAHLE, DONNA (LSW, CCDCI)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:KAHLE
Suffix:
Gender:F
Credentials:LSW, CCDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7561 WETHERSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8884
Mailing Address - Country:US
Mailing Address - Phone:513-688-0575
Mailing Address - Fax:
Practice Address - Street 1:7561 WETHERSFIELD DR
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8884
Practice Address - Country:US
Practice Address - Phone:513-688-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH991833-CCDCI104100000X
OHS-256641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker