Individual provider Active NPI

Kenoctaya Moneek Lindsey, SOCIAL WORKER

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1255009395
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901737-SUPV Issued in OH
Practice address
3965 Warrendale Rd
Cleveland, OH 44118-2321
Phone
(216) 288-9258
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1901737-SUPV OH Primary

Addresses

Primary practice location

3965 Warrendale Rd
Cleveland, OH 44118-2321

Mailing address

3965 Warrendale Rd
Cleveland, OH 44118-2321
Phone (216) 288-9258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230306002584 OH Practitioner - Clinical Social Worker 2365815768 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Feb 22, 2023 Accepting new patients

Locations

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1255009395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3965 WARRENDALE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441182321",
            "telephone_number": "216-288-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3965 WARRENDALE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441182321",
            "telephone_number": "216-288-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSEY",
        "first_name": "KENOCTAYA",
        "middle_name": "MONEEK",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901737-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.