Healthcare Provider Details

I. General information

NPI: 1366352007
Provider Name (Legal Business Name): KELLIE SHEETS ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3036 WERK RD
CINCINNATI OH
45211-7042
US

IV. Provider business mailing address

3036 WERK RD
CINCINNATI OH
45211-7042
US

V. Phone/Fax

Practice location:
  • Phone: 513-363-2616
  • Fax:
Mailing address:
  • Phone: 513-363-2616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.01993
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: