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General NPI Number Information
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NPI Number | 1316055007
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Entity Type | Individual
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Provider Name | KATHLEEN R TUSAIE PHD, PMHCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 4505 LOGAN WAY
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City | HUBBARD
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State | OH
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Zip | 44425-3311
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Country | US
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Telephone | 330-259-3664
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Fax | 330-259-3665
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Provider Business Mailing Address
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Address Line | 4505 LOGAN WAY
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City | HUBBARD
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State | OH
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Zip | 44425-3311
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Country | US
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Telephone | 330-259-3664
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Fax | 330-259-3665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN 140528
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | NS-06906
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | NS-06906
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | NS-06906
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | NS06906
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 364SP0810X
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Taxonomy Name | Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | NS06906
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License Number State | OH
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