Kenna Ruth Mycek, M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S-0900713 Issued in OH

Practice address

24629 Detroit Road Ste. #8
Westlake, OH 44145

Phone

(440) 933-2640

Fax

(440) 933-2640

NPI assigned

Dec 30, 2011

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Allied Behavioral Health Services, Incorporated

  • Psychologist
  • Fairview Park, OH
  • NPI 1902984248

  Clinical

  Medicare reassignment NPD
• Kenna R Mycek

  • Clinical Child & Adolescent Psychologist
  • Bay Village, OH
  • NPI 1063950269
  NPD (past) Authorized official
• Allied Behavioral Health Services, Incorporated

  • Community/Behavioral Health Agency
  • Fairview Park, OH
  • NPI 1942637491
  NPD (past)

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1285904748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24629 DETROIT ROAD STE. #8",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-933-2640",
            "fax_number": "440-933-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24629 DETROIT ROAD STE. #8",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-933-2640",
            "fax_number": "440-933-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYCEK",
        "first_name": "KENNA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S-0900713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Music Therapy Enrichment Center, Inc.
• Diana Mustafa
• Esraa Mustafa
• Emily Mustar
• My Family Practice Inc
• Craig A Myers, PA-C
• James H Myers, M.D.
• Mohamed S Naem, MD
• Christina Nagle, RBT
• Sandous Y Najjar, PA

• Clinical Social Worker in Westlake, OH
• Providers in Westlake, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.