Melanie Kennebeck, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.08281 Issued in OH

Practice address

420 Superior St
Sandusky, OH 44870-1849

Phone

(419) 626-5623

NPI assigned

May 3, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: melanie.kennebeckphd.p1@direct.ecchc.nextgenshare.com

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.

• Erie County Office of Auditor

  • Substance Abuse Rehabilitation Facility
  • Sandusky, OH
  • NPI 1396572046
  NPD (past)
• Erie County Office of Auditor

  • Community/Behavioral Health Agency
  • Sandusky, OH
  • NPI 1417798497

  Community/Behavioral Health

  NPD (past)
• Erie County Office of Auditor

  • Federally Qualified Health Center (FQHC)
  • Sandusky, OH
  • NPI 1528520608
  NPD (past)
• Erie County Office of Auditor

  • Federally Qualified Health Center (FQHC)
  • Norwalk, OH
  • NPI 1639783996
  NPD (past)

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1124517396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SUPERIOR ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448701849",
            "telephone_number": "419-626-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SUPERIOR ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448701849",
            "telephone_number": "419-626-5623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 W Parish St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448704877",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Addison St",
            "address_purpose": "LOCATION",
            "city": "Kelleys Island",
            "state": "OH",
            "postal_code": "434386500",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 Mason Rd W",
            "address_purpose": "LOCATION",
            "city": "Milan",
            "state": "OH",
            "postal_code": "448469500",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34 Executive Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "OH",
            "postal_code": "448572490",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 Sanford St",
            "address_purpose": "LOCATION",
            "city": "Vermilion",
            "state": "OH",
            "postal_code": "440891577",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Superior St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "44870",
            "country_code": "US",
            "telephone_number": "567-304-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEBECK",
        "first_name": "MELANIE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.08281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Keller, FNP
• Richard Ralph Keller, MD
• Todd Alan Keller, M.D.
• Tracy Beth Keller, RDH, EFDA
• Erika L. Kemp, OTR/L
• Carrie Kennedy, LISA
• Karen Kennedy, M.A. CCC-SLP
• Sheri Kershaw, NP-C
• Ashwin C Kesaria, M.D.
• Key Pain Management and Treatment Center, Inc

• All providers in Sandusky, OH
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.