Kennadi E Adams

Individual provider Active NPI Marriage & Family Therapist · Canton, OH

NPI 1467067710 · NPPES record last updated Jul 9, 2024

Key facts

NPI
1467067710
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
F2400390 (OH)
Practice address
624 Market Ave N
Canton, OH 44702-1017
Phone
(330) 493-4553
Fax
(330) 493-3761
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rising Behavioral Healthcare and Recovery, Inc. (30 clinicians)

Practice addresses (Care Compare)

624 Market Ave N
Canton, OH 44702-1017
Phone (330) 493-4553

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240506001565 OH Practitioner - Marriage and Family Therapist 5395185490 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
F2400390OHMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rising Behavioral Healthcare and Recovery Inc Current
since Mar 14, 2024
Accepting new patients
Phoenix Rising Behavioral Healthcare and Recovery, Inc Current
since Mar 14, 2024
Accepting new patients

Locations

1844 W State St
Alliance, OH 44601
Phone (330) 493-4553

624 Market Ave N
Canton, OH 44702
Phone (330) 454-7066

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X F2400390 OH Yes

Addresses

Primary practice location

624 Market Ave N
Canton, OH 44702-1017

Mailing address

624 Market Ave N
Canton, OH 44702-1017
Phone (330) 493-4553

Other practice location 1

1218 W State St
Alliance, OH 44601-4626
Phone (330) 493-4553 ext. 108

Other providers in Canton, OH

All providers in Canton, OH · Marriage & Family Therapist in Ohio

Sources for this page

Verify at the official NPI Registry.