Provider Demographics
NPI:1710166566
Name:KESSLER, MARGOT
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 BELDEN VILLAGE ST NW
Mailing Address - Street 2:STUITE 202
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2552
Mailing Address - Country:US
Mailing Address - Phone:330-244-8901
Mailing Address - Fax:330-491-0636
Practice Address - Street 1:4450 BELDEN VILLAGE ST NW
Practice Address - Street 2:STUITE 202
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2552
Practice Address - Country:US
Practice Address - Phone:330-244-8901
Practice Address - Fax:330-491-0636
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5989101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP29961Medicare PIN
OHQ14946Medicare UPIN