Kettle Cove Counseling, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KETTLE COVE COUNSELING, LLC

Practice address

8 Thorndike St
Beverly, MA 01915-5858

Phone

(617) 209-9330

NPI assigned

Nov 28, 2023

Last updated

Dec 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patrick Willwerth, M.ED., LADC-INPI 1124748132

Title

Owner/Counselor

Phone

(617) 209-9330

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick Willwerth, M.ED., LADC-I

  • Addiction (Substance Use Disorder) Counselor
  • Beverly, MA
  • NPI 1124748132
  NPD Authorized official

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1467228817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 THORNDIKE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155858",
            "telephone_number": "617-209-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 THORNDIKE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155858",
            "telephone_number": "617-209-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTLE COVE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "WILLWERTH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "617-209-9330",
        "authorized_official_credential": "M.ED., LADC-I"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Taylor Kenney, OD
• Caitlin Kenny, LICSW
• Joi Ellen Kenny, FAMILY PARTNER
• Patricia Anne Kenny, RN PCNS
• Alexandra Keresztes
• Bushra Khan, MD
• Shahrokh Charles Khani, MD PHD
• Srijesa Khasnabish, DO
• Samantha Norman Kheboian, LAT, ATC
• Ramsey Khudairi, DPT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Beverly, MA
• Providers in Beverly, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.