Basic Information
| Provider Information | |||||||||
| NPI: | 1518568450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAUZLICK | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | |||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 219 E WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | NAPOLEON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435451698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195920540 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 219 E WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | NAPOLEON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435451698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195920540 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2020 | ||||||||
| LastUpdateDate: | 11/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | S.1450888 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.