Healthcare Provider Details

I. General information

NPI: 1275459182
Provider Name (Legal Business Name): KAYLEN ACKERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5548 HILLIARD ROME OFFICE PARK
HILLIARD OH
43026-7286
US

IV. Provider business mailing address

5548 HILLIARD ROME OFFICE PARK
HILLIARD OH
43026-7286
US

V. Phone/Fax

Practice location:
  • Phone: 740-845-8652
  • Fax: 514-503-0899
Mailing address:
  • Phone: 740-845-8652
  • Fax: 514-503-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2613488
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: