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Individual

KATHERINE JEANETTE CHISOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
220 HARVARD AVE, TERRACE PARK, OH 45174-1112
(949) 939-8885
Mailing address
220 HARVARD AVE, TERRACE PARK, OH 45174-1112
(949) 939-8885

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
89473
CA
106H00000X
Marriage & Family Therapist
Primary
60098
CA
106H00000X
Marriage & Family Therapist
Primary
89473
CA
106H00000X
Marriage & Family Therapist
F.2500530
OH
171400000X
Health & Wellness Coach
89473
CA
171M00000X
Case Manager/Care Coordinator
89473
CA

Other

Enumeration date
04/19/2011
Last updated
03/12/2026
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