Samuel E Kisner II

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.2103203 Issued in OH

Practice address

17325 Euclid Ave Ste 4103
Cleveland, OH 44112-1262

Phone

(216) 232-5455

NPI assigned

Jun 3, 2020

Last updated

Mar 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kallous Minds Counseling LLC.

  • Professional Counselor
  • Cleveland, OH
  • NPI 1295310670
  NPD Authorized official
• De'Asia L. Thompson, Lisw, LLC

  dba Rise Counseing Group

  • Clinical Social Worker
  • Dayton, OH
  • NPI 1356857403

  Professional

  NPD (past)
• Peter James Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Bedford, OH
  • NPI 1184255549

  Case Management

  NPD (past)

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1699399774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1966 E 84TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034264",
            "telephone_number": "216-262-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17325 EUCLID AVE STE 4103",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121262",
            "telephone_number": "216-232-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISNER",
        "first_name": "SAMUEL",
        "middle_name": "E",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2103203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Jean Kish, LSW
• Calley Michelle Kish, LISW
• Frank D Kish, LISW
• Katie Elizabeth Kish, PHARMD
• Sophia Kish
• Natalie Kiss, DNP, CRNA
• Jonathan Kissam
• Jonathan Kissel, LISW-S
• Laurel M Kissel
• Wendy A Kissinger, DO

• Professional Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.