Healthcare Provider Details

I. General information

NPI: 1134038136
Provider Name (Legal Business Name): KATIE BYERS ED.S., NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MINK ST SW
PATASKALA OH
43062-9310
US

IV. Provider business mailing address

6539 SUMMIT RD SW
PATASKALA OH
43062-9806
US

V. Phone/Fax

Practice location:
  • Phone: 740-927-9046
  • Fax:
Mailing address:
  • Phone: 740-927-6926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number22546902
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: