Provider Demographics
NPI:1518107762
Name:COATE-ORTIZ, KATHLEEN ANNE (MSW, LISW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANNE
Last Name:COATE-ORTIZ
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW LISW
Mailing Address - Street 1:893 BIRCHMONT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4120
Mailing Address - Country:US
Mailing Address - Phone:614-538-1887
Mailing Address - Fax:
Practice Address - Street 1:4701 OLENTANGY RIVER RD STE 2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1954
Practice Address - Country:US
Practice Address - Phone:614-595-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-01
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00055401041C0700X
OHI 00055401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical