Individual provider Active NPI

Kaicee Kubicina, LPCC

  • Professional Counselor
  • Warren, OH
National Provider Identifier
1982111878
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1700490-SUPV Issued in OH
Practice address
318 Mahoning Ave NW
Warren, OH 44483-4605
Phone
(330) 395-9563
NPI assigned
Jan 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.1700490-SUPV OH Primary

Addresses

Primary practice location

318 Mahoning Ave NW
Warren, OH 44483-4605

Mailing address

4416 Broad St
Newton Falls, OH 44444-9765
Phone (330) 883-4445

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
I20240717002047 OH Practitioner - Mental Health Counselor 8123563848 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.1700490-SUPVOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Community Services, Inc CurrentSince Apr 20, 2024 Accepting new patients
Axess Family Services Inc Current Accepting new patients
Axess Family Services Inc CurrentSince Apr 20, 2024 Accepting new patients
Family & Community Services Inc CurrentSince Apr 20, 2024 Accepting new patients
Axess Family Services Inc CurrentSince Apr 20, 2024 Accepting new patients

Locations

1400 S Arlington St
Unit 38
Akron, OH 44306
Phone (330) 724-5471

390 Robinson Ave
Ste E
Barberton, OH 44203
Phone (330) 564-2697

5968 New Milford Rd
Ravenna, OH 44266

771 N Freedom St
Ravenna, OH 44266
Phone (330) 296-5552

150 E Market St
Warren, OH 44481
Phone (330) 394-6244

318 Mahoning Ave NW
Warren, OH 44483
Phone (330) 394-6342

4970 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-8237

Organizations & group practices 5

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": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1982111878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4416 BROAD ST",
            "city": "NEWTON FALLS",
            "state": "OH",
            "postal_code": "444449765",
            "telephone_number": "330-883-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MAHONING AVE NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444834605",
            "telephone_number": "330-395-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBICINA",
        "first_name": "KAICEE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1700490-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.