Healthcare Provider Details

I. General information

NPI: 1932046414
Provider Name (Legal Business Name): KRISTIN BERDAN MASTERS LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6780 COFFMAN RD
DUBLIN OH
43017-1027
US

IV. Provider business mailing address

5175 EMERALD PKWY
DUBLIN OH
43017-1008
US

V. Phone/Fax

Practice location:
  • Phone: 614-764-5900
  • Fax:
Mailing address:
  • Phone: 614-764-5913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberI.0900232-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: