Provider Demographics
NPI:1609179944
Name:VESSELS, KATHERINE (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:VESSELS
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 CRAMER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2586
Mailing Address - Country:US
Mailing Address - Phone:614-889-5722
Mailing Address - Fax:614-889-9335
Practice Address - Street 1:299 CRAMER CREEK CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2586
Practice Address - Country:US
Practice Address - Phone:614-889-5722
Practice Address - Fax:614-889-9335
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.08000171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2341719Medicaid