Individual provider Active NPI

Samuel Kuntz, LISW

  • Social Worker
  • Westlake, OH
National Provider Identifier
1528465598
Registry record updated Apr 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.1451245 Issued in OH
Practice address
24600 Center Ridge Rd Ste 130
Westlake, OH 44145-5679
Phone
(440) 570-3790
NPI assigned
Nov 19, 2014
Last updated
Apr 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.1451245 OH Primary

Addresses

Primary practice location

24600 Center Ridge Rd Ste 130
Westlake, OH 44145-5679

Mailing address

24600 Center Ridge Rd Ste 130
Westlake, OH 44145-5679
Phone (440) 570-3790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200305001893 OH Practitioner - Clinical Social Worker 8022444140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1451245OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586563200000",
    "number": "1528465598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24600 CENTER RIDGE RD STE 130",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455679",
            "telephone_number": "440-570-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24600 CENTER RIDGE RD STE 130",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455679",
            "telephone_number": "440-570-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZ",
        "first_name": "SAMUEL",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2020-04-11",
        "certification_date": "2020-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1451245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.