Provider Demographics
NPI:1578018586
Name:MONAHAN, KERRY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 CHATHAM LN
Mailing Address - Street 2:SUITE 112
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2418
Mailing Address - Country:US
Mailing Address - Phone:314-265-2175
Mailing Address - Fax:
Practice Address - Street 1:921 CHATHAM LN
Practice Address - Street 2:SUITE 112
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2418
Practice Address - Country:US
Practice Address - Phone:314-265-2175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7462103G00000X, 103TC0700X, 103TC2200X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities