Susan D. Kennedy, MS, NCC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.110216-SUPV Issued in OH

Practice address

1160 W Broad St
Columbus, OH 43222-1352

Phone

(614) 274-1455

Fax

(614) 274-1433

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Mental Health Counselor

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Lower Lights Christian Health Center, Inc.

  • Primary Care Clinic/Center
  • Columbus, OH
  • NPI 1033455209
  Medicare reassignment

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1265501670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 VINTAGE WOODS DRIVE",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "43026",
            "telephone_number": "614-445-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221352",
            "telephone_number": "614-274-1455",
            "fax_number": "614-274-1433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1791 Alum Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432071708",
            "country_code": "US",
            "telephone_number": "614-445-8131 x279",
            "fax_number": "614-827-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SUSAN",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.110216-SUPV",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2001031746",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0235855",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruthann C. Kennedy, APRN.CNP
• Samantha Kennedy
• Samuel Kennedy
• Shannon Kennedy
• Stacie R Kennedy, BSW
• Toccara Kennedy
• Willow Kennedy
• Julie Kennel, PHD, RD, LD
• Caitlin Anne Kennelly, DPT
• Julie Kennerly, PHARMD

• Mental Health Counselor in Columbus, OH
• Providers in Columbus, 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 Nov 1, 2023; 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.