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NPI Code Detail

MEDICARE: DR. SUSAN K KAHLE PHD

MEDICARE: DR. SUSAN K KAHLE PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPY10906FL
2103T00000XPsychologist5806OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3CP25725OTHEROHMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21015229OTHEROHWORKERS COMP

General Provider Information

NPI Number : 1366558645
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN K KAHLE PHD
Provider Business Mailing Address
First Line : 550 N MAIN ST UNIT B
Second Line :
City : SPRINGBORO
State : OH
Zip : 45066-7520
Country : US
Telephone Number : 937-901-3122
Fax Number : 937-748-8206
Provider Business Practice Location Address
First Line : 21 E STATE ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-4281
Country : US
Telephone Number : 574-546-1900
Fax Number : 574-546-1999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 02/04/2026

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