Provider Demographics
NPI:1760219083
Name:CASCIOTTA, KELLY E (LSW)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:E
Last Name:CASCIOTTA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8984
Mailing Address - Country:US
Mailing Address - Phone:614-890-0000
Mailing Address - Fax:
Practice Address - Street 1:6000 COOPER RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8984
Practice Address - Country:US
Practice Address - Phone:614-890-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.24110801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical