MEDICARE: MS. KATHLEEN J PEROUTKA

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	101YP2500X	Professional Counselor	E2063	OH

General Provider Information

NPI Number	:	1578868410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN J PEROUTKA

Provider Business Mailing Address
First Line	:	1845 PERSHING BLVD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45420-2426
Country	:	US
Telephone Number	:	937-239-0170
Fax Number	:

Provider Business Practice Location Address
First Line	:	3131 S DIXIE DR
Second Line	:	SUITE 534
City	:	MORAINE
State	:	OH
Zip	:	45439-2256
Country	:	US
Telephone Number	:	937-239-0170
Fax Number	:

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

Provider Enumeration Date	:	01/25/2011
Last Update Date	:	01/25/2011

Similar Medicare Providers

1912309006 — MISS COURTNEY BENTLEY LSW, CAA
Practice Location Address:

3131 S DIXIE DR , SUITE 220
MORAINE, OH
45439-2256

Practice Phone: 937-643-0398
Practice Fax: 937-643-0398

1306890926 — HEARTLAND HOME CARE LLC
Practice Location Address:

3131 S DIXIE DR , SUITE 221
DAYTON, OH
45439-2256

Practice Phone: 937-297-0548
Practice Fax: 937-297-0566

1841238003 — HEARTLAND HOME HEALTH CARE SERVICES, INC.
Practice Location Address:

3131 S DIXIE DR , SUITE 221
DAYTON, OH
45439-2256

Practice Phone: 937-297-0548
Practice Fax:

1780400192 — SYDNEY M SINES COUNSELOR TRAINEE
Practice Location Address:

3095 KETTERING BLVD
MORAINE, OH
45439-1983

Practice Phone: 937-293-8300
Practice Fax:

1790775914 — DR. DAVID WANJOHI KABITHE MD
Practice Location Address:

2016 SPRINGBORO W
MORAINE, OH
45439-1648

Practice Phone: 937-298-6777
Practice Fax: 937-298-6716

1285130468 — JUSTIN TODD NICOL CDCA, SWT
Practice Location Address:

3095 KETTERING BLVD
MORAINE, OH
45439-1983

Practice Phone: 937-293-8300
Practice Fax:

Directions to “ MS. KATHLEEN J PEROUTKA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.