1538244173 NPI number — KATHLEEN MARIE MEHOSKY MS,CCC-SLP

Table of content: KATHLEEN MARIE MEHOSKY MS,CCC-SLP (NPI 1538244173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538244173 NPI number — KATHLEEN MARIE MEHOSKY MS,CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEHOSKY
Provider First Name:
KATHLEEN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS,CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538244173
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 LOMBARDO CENTER
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
SEVEN HILLS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-749-6650
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5700 LOMBARDO CTR
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
SEVEN HILLS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44131-2540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-477-6650
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SP7649 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000217475 . This is a "ANTHEMBLUECROSS/BLUSHEILD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0842995 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: OH4655A . This is a "BEECH STREET CORPORATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 341929047 . This is a "TAX ID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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