Individual provider Active NPI

Megan Nicole Kyea, MSSA, LISW

  • Social Worker
  • Ashtabula, OH
National Provider Identifier
1851856017
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.190619 Issued in OH
Practice address
2210 S Ridge Rd E
Ashtabula, OH 44004-4459
Phone
(513) 834-7063
Fax
(513) 873-1567
NPI assigned
Feb 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I.1901619 OH
Social Worker 104100000X I.190619 OH Primary

Addresses

Primary practice location

2210 S Ridge Rd E
Ashtabula, OH 44004-4459

Mailing address

615 Elsinore PL Ste 200
Cincinnati, OH 45202-1459
Phone (513) 834-7063

Other practice location 1

7519 Mentor Ave Ste 114
Mentor, OH 44060-5410
Phone (440) 299-8674

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
I20191024003152 OH Practitioner - Clinical Social Worker 3173855038 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23850 Commerce Park
Beachwood, OH 44122-5829
Phone (440) 781-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1901619OHMDMental Health Counselor
I.190619OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stella Maris, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Adult Wellness Clinic LLC CurrentSince Feb 6, 2024 Accepting new patients
Stella Maris, Inc CurrentSince Jan 1, 2024 Accepting new patients
Integrated Behavioral and Primary Care LLC Mental Health CurrentSince Feb 10, 2021 Accepting new patients

Locations

23850 Commerce Park
Beachwood, OH 44122
Phone (440) 753-6030

23850 Commerce Park
Ste C
Beachwood, OH 44122
Phone (440) 219-0302

1302 Winslow Ave
Cleveland, OH 44113
Phone (216) 727-2053

1320 Washington Ave
Cleveland, OH 44113
Phone (216) 727-2086

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1851856017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021459",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 S RIDGE RD E",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044459",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7519 Mentor Ave Ste 114",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "440605410",
            "country_code": "US",
            "telephone_number": "440-299-8674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KYEA",
        "first_name": "MEGAN",
        "middle_name": "NICOLE",
        "credential": "MSSA, LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I.1901619",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.190619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.