Kenneth A Kish, LMSW, LMFT

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801014727 Issued in MI

Practice address

5671 N Skeel Ave Ste 4
Oscoda, MI 48750-1535

Phone

(989) 747-0026

Fax

(989) 747-0029

NPI assigned

Jul 13, 2006

Last updated

Oct 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

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.

• Ausable Valley Community Mental Health Services Board

  • Community/Behavioral Health Agency
  • Tawas City, MI
  • NPI 1417011701
  NPD (past)
• Oscoda VA Outpatient Clinic

  • Primary Care Clinic/Center
  • Oscoda, MI
  • NPI 1336243740
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1902821499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 N SKEEL AVE STE 4",
            "city": "OSCODA",
            "state": "MI",
            "postal_code": "487501535",
            "telephone_number": "989-747-0026",
            "fax_number": "989-747-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 N SKEEL AVE STE 4",
            "city": "OSCODA",
            "state": "MI",
            "postal_code": "487501535",
            "telephone_number": "989-747-0026",
            "fax_number": "989-747-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISH",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "LMSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801014727",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jarnagan
• Lacey Jane Jones
• Mark Jordan, PHARMACY GRADUATE
• Tressa Kendall, LBSW
• Frances Kerstholt-Sullivan, LBSW QMHP
• Emily Louise Kloska, DO
• Derek Emery Kohl
• Tatiana Olegovna Kriatchkova, PHARMD
• Kari Kubik
• Elise Langley, FNP-C

• Social Worker in Oscoda, MI
• Providers in Oscoda, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.