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NPI Code Detail

MEDICARE: KAITLYNN FUSON

MEDICARE: KAITLYNN FUSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1134803877
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYNN FUSON
Provider Business Mailing Address
First Line : 1550 SHERIDAN DR STE 302
Second Line :
City : LANCASTER
State : OH
Zip : 43130-1380
Country : US
Telephone Number : 740-901-3040
Fax Number :
Provider Business Practice Location Address
First Line : 319 W MARKET ST
Second Line :
City : LIMA
State : OH
Zip : 45801-4713
Country : US
Telephone Number : 740-901-3040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2023
Last Update Date : 08/23/2023

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Directions to “ KAITLYNN FUSON ” Practice Location

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