Individual provider Active NPI

Kimmeri Ventresca, LISW S

  • Clinical Social Worker
  • Akron, OH
National Provider Identifier
1457326407
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0700207 Issued in OH
Practice address
611 W Market St
Akron, OH 44303-1406
Phone
(330) 996-4600
Fax
(330) 564-9296
NPI assigned
Feb 22, 2006
Last updated
Sep 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S0030755 OH
Clinical Social Worker 1041C0700X I0700207 OH Primary

Addresses

Primary practice location

611 W Market St
Akron, OH 44303-1406

Mailing address

611 W Market St
Akron, OH 44303-1406
Phone (330) 996-4600

Other practice location 1

246 Northland Dr
#200A
Medina, OH 44256-1533
Phone (330) 725-9195 ext. 14

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0700207OHMDClinical Social Worker
S0030755OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1457326407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031406",
            "telephone_number": "330-996-4600",
            "fax_number": "330-564-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031406",
            "telephone_number": "330-996-4600",
            "fax_number": "330-564-9296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "246 Northland Dr",
            "address_2": "#200A",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442561533",
            "country_code": "US",
            "telephone_number": "330-725-9195 x14",
            "fax_number": "330-725-9187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENTRESCA",
        "first_name": "KIMMERI",
        "credential": "LISW S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S0030755",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0700207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.