Kairos Counseling LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KAIROS COUNSELING LCSW PLLC

Practice address

1870 Whitehaven Rd
Grand Island, NY 14072-1804

Phone

(716) 453-4839

NPI assigned

Apr 17, 2024

Organization subpart

No

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

Authorized official

Name

Samantha ZimmermannNPI 1417404567

Title

Licensed Clinical Social Worker

Phone

(716) 453-4839

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Leigh Zimmermann

  • Clinical Social Worker
  • Grand Island, NY
  • NPI 1417404567
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1801640503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 WHITEHAVEN RD",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140721804",
            "telephone_number": "716-453-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 WHITEHAVEN RD",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140721804",
            "telephone_number": "716-453-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS COUNSELING LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMANN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "716-453-4839"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michelle Anne Kehoe, MS.ED, ED.M.

• Clinical Social Worker in Grand Island, NY
• Providers in Grand Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.