Kenneth Stahl, LPCC-S, LICDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E1700041-SUPV Issued in OH

Practice address

4879 US Highway 68 S
West Liberty, OH 43357

Phone

(937) 599-1411

Fax

(937) 599-4128

NPI assigned

Feb 13, 2017

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.stahl@chwplc.eclinicaldirectplus.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.

• Community Health & Wellness Partners of Logan County

  • Community Health Clinic/Center
  • West Liberty, OH
  • NPI 1689005357
  Medicare reassignment NPD
• Community Health & Wellness Partners of Logan County

  • Student Health Clinic/Center
  • Saint Paris, OH
  • NPI 1205641388
  NPD
• Community Health & Wellness Partners of Logan County

  • Community Health Clinic/Center
  • Bellefontaine, OH
  • NPI 1982360533
  NPD
• Community Health & Wellness Partners of Logan County

  • Student Health Clinic/Center
  • West Liberty, OH
  • NPI 1083215875
  NPD (past)
• Community Health & Wellness Partners of Logan County

  • Federally Qualified Health Center (FQHC)
  • De Graff, OH
  • NPI 1447965058
  NPD (past)
• Community Health & Wellness Partners of Logan County

  • Federally Qualified Health Center (FQHC)
  • Russells Point, OH
  • NPI 1962828293
  NPD (past)

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1285173179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4879 US HIGHWAY 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579525",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4879 US HIGHWAY 68 S",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "43357",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "KENNETH",
        "credential": "LPCC-S, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161786",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E1700041-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0213436",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice E Rhoades, LISW LICDC
• Brian Lynn Schmidt, D.O.
• Marcy D Semler
• Trena Shank
• Beverly Smith
• Douglas Howard Steiner, MA MSW LISW
• Theresa Ann Stevens
• Carol Stewart
• Paula A Strebig, CNP
• Steven R Toney, M.D.

• Professional Counselor in West Liberty, OH
• Providers in West Liberty, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.