Provider Demographics
NPI:1851024962
Name:DEWESE, KAYLIN SARAH (BSW, LSW)
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:SARAH
Last Name:DEWESE
Suffix:
Gender:F
Credentials:BSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3185 CARROLL EASTERN RD
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:OH
Mailing Address - Zip Code:43112-9646
Mailing Address - Country:US
Mailing Address - Phone:740-503-9286
Mailing Address - Fax:
Practice Address - Street 1:65 MESSIMER DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1874
Practice Address - Country:US
Practice Address - Phone:740-522-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health