MEDICARE: KENNY KINDER LSW

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker		OH
2	376J00000X	Homemaker		OH
3	104100000X	Social Worker	2005164	OH

General Provider Information

NPI Number	:	1487241287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNY KINDER LSW

Provider Business Mailing Address
First Line	:	4122 W 57TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-1852
Country	:	US
Telephone Number	:	440-834-2987
Fax Number	:

Provider Business Practice Location Address
First Line	:	4122 W 57TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-1852
Country	:	US
Telephone Number	:	440-834-2987
Fax Number	:

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

Provider Enumeration Date	:	12/28/2020
Last Update Date	:	01/25/2022

Similar Medicare Providers

1851128771 — MRS. MARIA CHAMORRO
Practice Location Address:

4162 W 57TH ST
CLEVELAND, OH
44144-1852

Practice Phone: 325-812-3646
Practice Fax:

1053612952 — MRS. ROCHELLE NICHAE PASCHAL R.N.
Practice Location Address:

3399 DESOTA AVE
CLEVELAND HTS, OH
44118-1852

Practice Phone: 216-320-0640
Practice Fax:

1700388972 — MELODY J ARBOUR LSW
Practice Location Address:

9500 DETROIT AVE
CLEVELAND, OH
44102-1852

Practice Phone: 216-283-4400
Practice Fax: 216-283-5359

1225523814 — SHANTEE M WILBURN QMHS
Practice Location Address:

9500 DETROIT AVE
CLEVELAND, OH
44102-1852

Practice Phone: 216-283-4400
Practice Fax: 216-283-5359

1164917753 — PHILLIP M SPECK QMHS
Practice Location Address:

9500 DETROIT AVE
CLEVELAND, OH
44102-1852

Practice Phone: 216-283-4400
Practice Fax: 216-283-5359

1811471568 — ADRIENNE BROWN QMHS
Practice Location Address:

9500 DETROIT AVE
CLEVELAND, OH
44102-1852

Practice Phone: 216-283-4400
Practice Fax: 216-283-5359

Directions to “ KENNY KINDER LSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.