Kenneth M Kinzie, M.S.W., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW1660 Issued in FL

Practice address

73 S Palm Ave
Suite 215
Sarasota, FL 34236-5638

Phone

(941) 374-3846

Fax

(941) 751-4885

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ken Kinzie Professional name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellness Psychological Services, PLLCGroup PAC ID 4587969977, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellness Psychological Services PLLC

  • Counseling Psychologist
  • Tampa, FL
  • NPI 1154794881
  Medicare reassignment Care Compare group NPD
• Kinzie Counseling & Consultation LLC

  • Clinical Social Worker
  • Sarasota, FL
  • NPI 1407072457
  NPD (past) Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104980499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 QUONSET RD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342039730",
            "telephone_number": "941-374-3846",
            "fax_number": "941-751-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 S PALM AVE",
            "address_2": "SUITE 215",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365638",
            "telephone_number": "941-374-3846",
            "fax_number": "941-751-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINZIE",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "M.S.W., LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEN",
            "last_name": "KINZIE",
            "credential": "M.S.W., LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Scott J King, M.D.
• Sydney William King, M.D.
• Kinga Kondor-Hine
• Kingdom Wellness
• Kinzie Counseling & Consultation LLC
• Brian Kiracofe
• Deborah Lynn Kirby, LCSW
• Cynthia Milos Kirchberg, OTL
• Kirk G Voelker MD PA
• Courtney Kirkland, DO

• Clinical Social Worker in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.