Misra, Kiersten

Misra, Kiersten is an sole proprietor health care provider with primary practice located at 3131 Executive Pkwy Ste 205 , Toledo OH 43606-1327. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Misra, Kiersten can be contacted via phone (419) 360-7026.

Contact Information

Primary practice address
3131 Executive Pkwy Ste 205 Toledo OH 43606-1327
Phone: (419) 360-7026
Fax: (419) 482-1262
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LICDC.161602 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.1801351-SUPV Ohio

Profile Details

NPI number 1780137950
LBN Legal business name Misra, Kiersten
Credentials MSW, LISW-S, LICDC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 25th, 2016
Last updated Jan 26th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780137950 NPPES
Ohio MEDICAID 0360500
Ohio Other 1972140044

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