Kenneth T Cappuccio LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04533100 Issued in NJ

Legal business name

KENNETH T CAPPUCCIO LLC

Practice address

2195 Haystack Way
Myrtle Beach, SC 29579-3276

Phone

(908) 447-2913

NPI assigned

Jan 29, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Thomas CappuccioNPI 1073674776

Title

President

Phone

(908) 447-2913

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Thomas Cappuccio, LCSW

  • Clinical Social Worker
  • Myrtle Beach, SC
  • NPI 1073674776

  SC

  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1023295367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 HAYSTACK WAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793276",
            "telephone_number": "908-447-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 HAYSTACK WAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793276",
            "telephone_number": "908-447-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH T CAPPUCCIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "CAPPUCCIO",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-447-2913"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04533100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kemper Therapy Group LLC
• Devin A Kemper, CCC-SLP
• Jessica Kendall, ATC, LAT
• Adam Kendig, PTA
• Amber Elizabeth Kendig, MS, CCC-SLP
• Heather Kerble
• William Kerr
• Derek David Kestila, DO
• Keys to Health and Wellness
• Michelle Marie Keys, MA

• All providers in Myrtle Beach, SC
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.