Provider Demographics
NPI:1134791296
Name:KUMTHEKAR, KATHERINE RACHEL (LSW)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:RACHEL
Last Name:KUMTHEKAR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2032
Mailing Address - Country:US
Mailing Address - Phone:412-638-5580
Mailing Address - Fax:
Practice Address - Street 1:1785 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2032
Practice Address - Country:US
Practice Address - Phone:412-638-5580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2106014104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker