Kenneth Phillip Buzzelli, LISW LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0001123 Issued in OH

Practice address

1865 Bailey Rd
Cuyahoga Falls, OH 44221-5211

Phone

(330) 928-2042

NPI assigned

Aug 3, 2006

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

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Psychiatric Services, Inc.Group PAC ID 5395710230, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbuzzelli122003@direct.chmca.org

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.

• Comprehensive Psychiatric Services, Inc.

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1740393545
  Medicare reassignment Care Compare group
• Hope Behavioral Health LLC

  • Clinical Social Worker
  • Beachwood, OH
  • NPI 1821432758
  Medicare reassignment NPD
• Child Guidance & Family Solutions

  • Adolescent and Children Mental Health Clinic/Center
  • Akron, OH
  • NPI 1922105147
  Medicare reassignment
• Akron Children'S Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Ohio Gambling Telehealth Network

  • Community/Behavioral Health Agency
  • Columbus, OH
  • NPI 1720865579
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1972510568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24400 HIGHPOINT RD",
            "address_2": "SUITE #6",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "216-831-6550",
            "fax_number": "216-831-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 BAILEY RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442215211",
            "telephone_number": "330-928-2042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24400 Highpoint Rd",
            "address_2": "Suite #6",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "44124",
            "country_code": "US",
            "telephone_number": "216-831-6550",
            "fax_number": "216-831-6133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUZZELLI",
        "first_name": "KENNETH",
        "middle_name": "PHILLIP",
        "name_prefix": "Mr.",
        "credential": "LISW LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "0001123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0001123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "196677000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS - FACILITY",
            "identifier": "343178",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rex Burkland
• Gervaise Burks
• Christopher B Bursley, M.D.
• Dawn M Bush, MA, CCC-SLP
• Olive Pearl Busson, PTA
• Paris Leigh Byrd
• Caroline Anne Byrne, SPEECH-LANGUAGE PATH
• C & V Enterprise LLC
• Amelia Calderone Tharpe, OTR/L
• Nancy Caldwell, LPCC

• Clinical Social Worker in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.