MEDICARE: CARL KAPPENHAGEN OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372600000X	Adult Companion
2	101Y00000X	Counselor
3	101YM0800X	Mental Health Counselor
4	101YP2500X	Professional Counselor
5	101YS0200X	School Counselor
6	133NN1002X	Nutrition Education Nutritionist
7	224Z00000X	Occupational Therapy Assistant
8	225800000X	Recreation Therapist
9	251C00000X	Developmentally Disabled Services Day Training Agency
10	253Z00000X	In Home Supportive Care Agency
11	372500000X	Chore Provider
12	374U00000X	Home Health Aide
13	376J00000X	Homemaker
14	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1255995080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL KAPPENHAGEN OT

Provider Business Mailing Address
First Line	:	4350 W 28TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4167
Country	:	US
Telephone Number	:	216-356-2380
Fax Number	:

Provider Business Practice Location Address
First Line	:	4350 W 28TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4167
Country	:	US
Telephone Number	:	216-356-2380
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2019
Last Update Date	:	05/18/2019

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Directions to “ CARL KAPPENHAGEN OT” Practice Location

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