Active NPI
Sean M Kuykendall, MSW LCSW
- Clinical Social Worker
- Evansville, IN
National Provider Identifier
1497766539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34004820A
- Practice address
- 101 N Barker Ave
Evansville, IN 47712-5615 - Phone
- (812) 426-2499
- Fax
- (812) 422-7558
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 34004820A | IN | Primary |
Addresses
Primary practice location
101 N Barker Ave
Evansville, IN 47712-5615
Mailing address
415 Mulberry St
Evansville, IN 47713-1230
Phone (812) 423-7791
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000334233 | Other | IN | ANTHEM |
| 100240880 | Medicaid | IN |
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 |
|---|---|---|---|
| 34004820A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwestern Behavioral Healthcare, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Evansville, IN
- NPI 1033108766
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271721600000",
"number": "1497766539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 MULBERRY ST",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131230",
"telephone_number": "812-423-7791",
"fax_number": "812-422-7558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N BARKER AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477125615",
"telephone_number": "812-426-2499",
"fax_number": "812-422-7558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUYKENDALL",
"first_name": "SEAN",
"middle_name": "M",
"credential": "MSW LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2010-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34004820A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000334233",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100240880",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.