Provider Demographics
NPI:1831899319
Name:PAINTER, KATHLEEN (CDCA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PAINTER
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:GARTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCA PRELIMINARY
Mailing Address - Street 1:1815 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7000
Mailing Address - Country:US
Mailing Address - Phone:855-747-4673
Mailing Address - Fax:
Practice Address - Street 1:1815 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313
Practice Address - Country:US
Practice Address - Phone:855-747-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.184709171M00000X, 101YA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator