Active NPI
Kimm Cynkar, LISW LICDC
- Clinical Social Worker
- Columbus, OH
National Provider Identifier
1467672147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I 0008814
- Practice address
- 1910 Crown Park CT
Columbus, OH 43235-2404 - Phone
- (614) 457-8359
- Fax
- (614) 457-6898
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I 0008814 | OH | Primary |
Addresses
Primary practice location
1910 Crown Park CT
Columbus, OH 43235-2404
Mailing address
4352 Woodstream Dr
Gahanna, OH 43230-4159
Phone (614) 519-6025
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
| License | State | Type | Specialty |
|---|---|---|---|
| I 0008814 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467672147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4352 WOODSTREAM DR",
"city": "GAHANNA",
"state": "OH",
"postal_code": "432304159",
"telephone_number": "614-519-6025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 CROWN PARK CT",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432352404",
"telephone_number": "614-457-8359",
"fax_number": "614-457-6898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CYNKAR",
"first_name": "KIMM",
"credential": "LISW LICDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I 0008814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.