Provider Demographics
NPI:1750864765
Name:OHMAN, KATHLEEN M (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:M
Last Name:OHMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 THOMAS CT
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02638-2200
Mailing Address - Country:US
Mailing Address - Phone:508-280-5426
Mailing Address - Fax:
Practice Address - Street 1:12 THOMAS CT
Practice Address - Street 2:
Practice Address - City:DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02638-2200
Practice Address - Country:US
Practice Address - Phone:508-280-5426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106015-SW-LICSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker