| Doctor Name: | MR. KENNETH TODD KIRKSEY |
| NPI Number: | 1033363544 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW-S, CEAP |
| License Number: | I. 0008323SUPV |
| Business Practice Address: | 60 W Columbus St Pickerington, OH - 431471256 |
| Business Phone Number: | 6148370063 |
| Business Fax Number: | 6148370112 |
| Mailing Address: | Po Box 1600, REYNOLDSBURG |
| State: | OH |
| Postal Code: | 430686600 |
| Phone Number: | 6145821835 |
| Fax Number: | 6148370112 |
| NPI Enumeration Date: | 11/11/2008 |
| NPI Last Update Date: | 11/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I. 0008323SUPV |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |