Pamela Sue Kucklick, LPCC-S-SUPV

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.0006764-SUPV Issued in OH

Practice address

4115 Bridge Ave
Cleveland, OH 44113-3304

Phone

(216) 651-5800

NPI assigned

Dec 3, 2014

Sex

Female

Sole proprietor

No

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Near West Side Multi Service CorporationGroup PAC ID 7911139381, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Near West Side Multi Service Corporation

  • Community/Behavioral Health Agency
  • Cleveland, OH
  • NPI 1184960510
  Medicare reassignment Care Compare group NPD
• Near West Side Multi Service Corporation

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cleveland, OH
  • NPI 1184194045
  NPD

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1245637446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 W 38TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132802",
            "telephone_number": "216-906-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 BRIDGE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133304",
            "telephone_number": "216-651-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCKLICK",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LPCC-S-SUPV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0006764-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Kubu, PHD
• Kevin Kucera, OT
• Nicholas Kucher
• Candace Kucherak
• Cassandra E Kuchta, PA-C
• Marcia A Kucler, CNS
• Mark J Kuczmarski, CRNA
• Abhijith Kudaravalli, DO
• Margaret Kuder
• Jordan Elizabeth Kudla, P.A.

• Mental Health Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; 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.