Individual
KALYSSA DEKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
495 E MAIN ST STE A, COLUMBUS, OH 43215-5349
(614) 355-8055
Mailing address
DEPT 781625 PO BOX 78000, DETROIT, MI 48278-1625
(614) 355-8004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C.1901696
OH
101YP2500X
Professional Counselor
Primary
E.2102095
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
12/17/2018
Last updated
01/26/2021
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