Provider Demographics
NPI:1285484261
Name:MARIOTH, KARSEN NICHOLE
Entity type:Individual
Prefix:
First Name:KARSEN
Middle Name:NICHOLE
Last Name:MARIOTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2939 GRATZ RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-3780
Mailing Address - Country:US
Mailing Address - Phone:614-370-7660
Mailing Address - Fax:
Practice Address - Street 1:527 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5602
Practice Address - Country:US
Practice Address - Phone:614-227-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No104100000XBehavioral Health & Social Service ProvidersSocial Worker