Individual provider Active NPI

Sarah Katherine Kuykendall, LCSW

  • Clinical Social Worker
  • New Smyrna Beach, FL
National Provider Identifier
1376794610
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13079 Issued in FL
Practice address
136 Julia St Unit 100
New Smyrna Beach, FL 32168-7713
Phone
(386) 423-9161
Fax
(386) 423-3094
NPI assigned
Oct 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1958 KS
Clinical Social Worker 1041C0700X SW13079 FL Primary

Addresses

Primary practice location

136 Julia St Unit 100
New Smyrna Beach, FL 32168-7713

Mailing address

136 Julia St Unit 100
New Smyrna Beach, FL 32168-7713
Phone (386) 423-9161

Other identifiers 1

IdentifierTypeStateIssuer
016801018OtherKSMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160926000087 FL Practitioner - Clinical Social Worker 7911156674 Practice locations: New Smyrna Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

136 Julia St
Unit 100
New Smyrna Beach, FL 32168-7713
Phone (386) 423-9161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1958KSMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1376794610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JULIA ST UNIT 100",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687713",
            "telephone_number": "386-423-9161",
            "fax_number": "386-423-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 JULIA ST UNIT 100",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687713",
            "telephone_number": "386-423-9161",
            "fax_number": "386-423-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUYKENDALL",
        "first_name": "SARAH",
        "middle_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "1958",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "016801018",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.