Katherine Jeanette Chisom, M.A.
Individual provider Active NPI Marriage & Family Therapist · Terrace Park, OH
NPI 1083904445 · NPPES record last updated Mar 12, 2026
Key facts
- NPI
- 1083904445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 89473 (CA)
- Practice address
- 220 Harvard Ave
Terrace Park, OH 45174-1112 - Phone
- (949) 939-8885
- NPI assigned
- Apr 19, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89473 | CA | MD | Mental Health Counselor |
| F.2500530 | OH | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | 89473 | CA | |
| Marriage & Family Therapist | 106H00000X | F.2500530 | OH | |
| Mental Health Counselor | 101YM0800X | 89473 | CA | |
| Case Manager/Care Coordinator | 171M00000X | 89473 | CA | |
| Marriage & Family Therapist | 106H00000X | 89473 | CA | Yes |
Addresses
Primary practice location
220 Harvard Ave
Terrace Park, OH 45174-1112
Mailing address
220 Harvard Ave
Terrace Park, OH 45174-1112
Phone (949) 939-8885
Other names
- Katy Jeanette Chevalier
Other providers in Terrace Park, OH
- Lauren Barrett
- Amy E Carlier
- Cincinnati Massage for Mental Health Dba Node & Needle
- Gretchen Patsy Dooley
- Caroline Hall France
- David Lee Fritz
- Lawrence P Wang MD LLC
All providers in Terrace Park, OH · Marriage & Family Therapist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.