Active NPI
Timothy Russell Kenepp, LSW, CRS A/D
- Social Worker
- Cleveland, OH
National Provider Identifier
1780011171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1101368
- Practice address
- 1700 E 13TH St Ste 114
Cleveland, OH 44114-3285 - Phone
- (216) 539-9239
- NPI assigned
- Oct 1, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1101368 | OH | Primary |
Addresses
Primary practice location
1700 E 13TH St Ste 114
Cleveland, OH 44114-3285
Mailing address
1665 Greenlawn Ave
Akron, OH 44301-2743
Phone (330) 319-3076
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1101368 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1780011171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 GREENLAWN AVE",
"city": "AKRON",
"state": "OH",
"postal_code": "443012743",
"telephone_number": "330-319-3076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E 13TH ST STE 114",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441143285",
"telephone_number": "216-539-9239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENEPP",
"first_name": "TIMOTHY",
"middle_name": "RUSSELL",
"credential": "LSW, CRS A/D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-01",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1101368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.