Provider Demographics
NPI:1578651915
Name:SABOL, KATHLEEN RAE (MSED, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:RAE
Last Name:SABOL
Suffix:
Gender:F
Credentials:MSED, LPCC
Other - Prefix:MRS
Other - First Name:KATHLEEN
Other - Middle Name:RAE
Other - Last Name:TARTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED, LPCC
Mailing Address - Street 1:6810 RUBY CTS
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-5610
Mailing Address - Country:US
Mailing Address - Phone:330-793-1372
Mailing Address - Fax:
Practice Address - Street 1:104 JAVIT CT
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2409
Practice Address - Country:US
Practice Address - Phone:330-797-4050
Practice Address - Fax:330-797-4090
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0002683101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2047396Medicaid
OH2047396Medicaid