Provider Demographics
NPI:1518178086
Name:KALIN, THOMAS C (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:KALIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7654 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4204
Mailing Address - Country:US
Mailing Address - Phone:513-791-5150
Mailing Address - Fax:513-791-8873
Practice Address - Street 1:7654 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4204
Practice Address - Country:US
Practice Address - Phone:513-791-5150
Practice Address - Fax:513-791-8873
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3301103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311105617-00OtherBWC
OH0536414Medicaid
OHKACP02281Medicare ID - Type Unspecified