Basic Information
Provider Information
NPI: 1932725348
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZANE
FirstName: KATHERINE
MiddleName: LEWIS
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7527
Address2:  
City: DUBLIN
State: OH
PostalCode: 430170727
CountryCode: US
TelephoneNumber: 6145446155
FaxNumber: 6145446370
Practice Location
Address1: 931 CHATHAM LN
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432212417
CountryCode: US
TelephoneNumber: 6145335500
FaxNumber: 6145330103
Other Information
ProviderEnumerationDate: 06/22/2020
LastUpdateDate: 12/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X1246WVN Behavioral Health & Social Service ProvidersPsychologist 
103TC0700XP.08055OHY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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