Provider Demographics
NPI:1932955754
Name:BARTH, KAHLA (CDCA-I)
Entity Type:Individual
Prefix:
First Name:KAHLA
Middle Name:
Last Name:BARTH
Suffix:
Gender:F
Credentials:CDCA-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8785 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6209
Mailing Address - Country:US
Mailing Address - Phone:440-701-6590
Mailing Address - Fax:
Practice Address - Street 1:8785 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6209
Practice Address - Country:US
Practice Address - Phone:440-701-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.188072101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)