Provider Demographics
NPI:1447314489
Name:DELMORE, KIRSTEN E (MSW, LISW)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:E
Last Name:DELMORE
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-0206
Mailing Address - Country:US
Mailing Address - Phone:614-888-8400
Mailing Address - Fax:614-888-8416
Practice Address - Street 1:1303 JASPER LN
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-3561
Practice Address - Country:US
Practice Address - Phone:614-888-8400
Practice Address - Fax:614-888-8416
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00089131041C0700X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000290459OtherANTHEM