Provider Demographics
NPI:1609542224
Name:PREZIOSO, KATHERINE (LISW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:PREZIOSO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:PREZIOSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2790 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-3116
Mailing Address - Country:US
Mailing Address - Phone:330-883-6394
Mailing Address - Fax:
Practice Address - Street 1:132 WESTCHESTER DR STE 1
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3993
Practice Address - Country:US
Practice Address - Phone:330-286-2996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHI.25064581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker