Healthcare Provider Details

I. General information

NPI: 1881415529
Provider Name (Legal Business Name): KIZAUR COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 OAK ALLEY CT STE 400
TOLEDO OH
43606-1355
US

IV. Provider business mailing address

3454 OAK ALLEY CT STE 400
TOLEDO OH
43606-1355
US

V. Phone/Fax

Practice location:
  • Phone: 419-367-9646
  • Fax:
Mailing address:
  • Phone: 419-367-9646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW WILLIAM KIZAUR
Title or Position: CO-FOUNDER
Credential: MA, LPCC
Phone: 419-367-9646