Provider Demographics
NPI:1932804887
Name:DOVE, KATHRYN MICHELE (LISW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MICHELE
Last Name:DOVE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7044 LINBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-2126
Mailing Address - Country:US
Mailing Address - Phone:614-404-0405
Mailing Address - Fax:
Practice Address - Street 1:7044 LINBROOK BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-2126
Practice Address - Country:US
Practice Address - Phone:614-404-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical