Individual provider Active NPI

Kyle Joesph Kravetz, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
National Provider Identifier
1356140750
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.191617 Issued in OH
Practice address
4705 State Rd
Cleveland, OH 44109-5244
Phone
(440) 468-6550
Fax
(440) 848-8894
NPI assigned
Mar 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CDCA.191617 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.191617 OH Primary

Addresses

Primary practice location

4705 State Rd
Cleveland, OH 44109-5244

Mailing address

1980 Brookpark Rd
Cleveland, OH 44109-5810
Phone (216) 396-4565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.191617OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Empower DW Corp Community/Behavioral Health CurrentSince Mar 20, 2025 Accepting new patients

Locations

4705 State Rd
Cleveland, OH 44109
Phone (440) 468-6550

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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1356140750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 BROOKPARK RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441095810",
            "telephone_number": "216-396-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 STATE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441095244",
            "telephone_number": "440-468-6550",
            "fax_number": "440-848-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVETZ",
        "first_name": "KYLE",
        "middle_name": "JOESPH",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "CDCA.191617",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.191617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.