Healthcare Provider Details

I. General information

NPI: 1356703086
Provider Name (Legal Business Name): KATHERINE BADERTSCHER MSW, LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W NORTH AVE
ADA OH
45810-1176
US

IV. Provider business mailing address

725 W NORTH AVE
ADA OH
45810-1176
US

V. Phone/Fax

Practice location:
  • Phone: 419-634-2341
  • Fax:
Mailing address:
  • Phone: 419-634-2341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberI.2304382
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: