Healthcare Provider Details

I. General information

NPI: 1417615618
Provider Name (Legal Business Name): ELIZABETH CATHERINE KAHNY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2021
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 EXECUTIVE PARK DR STE 320
CINCINNATI OH
45241-4015
US

IV. Provider business mailing address

4015 EXECUTIVE PARK DR STE 320
CINCINNATI OH
45241-4015
US

V. Phone/Fax

Practice location:
  • Phone: 513-563-0488
  • Fax:
Mailing address:
  • Phone: 513-563-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34008460A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1600099-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: