Provider Demographics
NPI:1770890576
Name:KAYE MAYNARD COUNSELING INC
Entity type:Organization
Organization Name:KAYE MAYNARD COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:740-963-2976
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:7257 E. BROAD ST. SW, UNIT C
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-0292
Mailing Address - Country:US
Mailing Address - Phone:740-963-2976
Mailing Address - Fax:740-927-0461
Practice Address - Street 1:7257 E BROAD ST SW UNIT C
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8501
Practice Address - Country:US
Practice Address - Phone:740-963-2976
Practice Address - Fax:740-927-0461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 10000631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0066911Medicaid