Provider Demographics
NPI:1548662240
Name:KEARNS, KRISTINA (MSW, LISW-S)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:KEARNS
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5740 STEFFY HAMBEL LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERHILL
Mailing Address - State:OH
Mailing Address - Zip Code:43728-9035
Mailing Address - Country:US
Mailing Address - Phone:864-310-5420
Mailing Address - Fax:864-310-5420
Practice Address - Street 1:5740 STEFFY HAMBEL LN
Practice Address - Street 2:
Practice Address - City:CHESTERHILL
Practice Address - State:OH
Practice Address - Zip Code:43728-9035
Practice Address - Country:US
Practice Address - Phone:864-310-5420
Practice Address - Fax:864-310-5420
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2006301041C0700X
OHI.1200630-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0166439Medicaid