Healthcare Provider Details

I. General information

NPI: 1306766852
Provider Name (Legal Business Name): KALEIGH MARTIN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SHAWNEE RD
LIMA OH
45805-3529
US

IV. Provider business mailing address

1100 SHAWNEE RD
LIMA OH
45805-3529
US

V. Phone/Fax

Practice location:
  • Phone: 419-999-2010
  • Fax: 419-991-0909
Mailing address:
  • Phone: 419-999-2010
  • Fax: 419-991-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1502359
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: