Provider Demographics
NPI:1942292156
Name:KLUSMAN, PAULA J (LPCC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:KLUSMAN
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 1:2330 VICTORY PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2839
Mailing Address - Country:US
Mailing Address - Phone:513-221-2330
Mailing Address - Fax:513-221-8954
Practice Address - Street 1:2330 VICTORY PKWY
Practice Address - Street 2:SUITE 500
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2839
Practice Address - Country:US
Practice Address - Phone:513-221-2330
Practice Address - Fax:513-221-8954
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0002822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000219299OtherANTHEM BC/BS OF OH
326748OtherMANAGED HEALTH NET
OH2842839OtherMEDICAID - FOR MED HMO ONLY
471294000OtherMAGELLAN BEHAVIORAL HEALT