MEDICARE: KARLEIA KERSTETTER

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
1	1041C0700X	Clinical Social Worker	S.1700268-TRNE	OH

General Provider Information

NPI Number	:	1437637006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLEIA KERSTETTER

Provider Business Mailing Address
First Line	:	263 MORRISON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2122
Country	:	US
Telephone Number	:	330-806-9626
Fax Number	:

Provider Business Practice Location Address
First Line	:	3645 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7752
Country	:	US
Telephone Number	:	614-457-7876
Fax Number	:	614-457-7896

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2018
Last Update Date	:	08/05/2018

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Directions to “ KARLEIA KERSTETTER ” Practice Location

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