Provider Demographics
NPI:1043318934
Name:WISNE, KATHRYN M (LPCC)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:M
Last Name:WISNE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E CAMPUS VIEW BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5691
Mailing Address - Country:US
Mailing Address - Phone:614-310-1234
Mailing Address - Fax:614-310-1237
Practice Address - Street 1:1 E CAMPUS VIEW BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5691
Practice Address - Country:US
Practice Address - Phone:614-310-1234
Practice Address - Fax:614-310-1237
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2059101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1316973431OtherNPI FOR PRACTICE