Provider Demographics
NPI:1528222445
Name:LARIMORE, KENNETH MARTIN (LISW)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:MARTIN
Last Name:LARIMORE
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CENTRAL CTR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2253
Mailing Address - Country:US
Mailing Address - Phone:740-771-9022
Mailing Address - Fax:740-331-7555
Practice Address - Street 1:20 CENTRAL CTR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2253
Practice Address - Country:US
Practice Address - Phone:740-771-9022
Practice Address - Fax:740-331-7555
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00306611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical