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KEVIN PATRICK FENNELL LSW CCDC1 NPI 1518072404


NPI Information

NPI: 1518072404
Provider Name: KEVIN PATRICK FENNELL, LSW, CCDC1
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
1791 ALUM CREEK DR
COLUMBUS, OH
ZIP 43207
Phone: (614) 324-5414
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Kevin Patrick Fennell, LSW, CCDC1 is a clinical social worker in Columbus, OH. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Kevin Patrick Fennell, LSW, CCDC1 NPI is 1518072404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1791 ALUM CREEK DR
COLUMBUS, OH
ZIP 43207-708
Phone: (614) 324-5414

The enumeration date for this NPI number is 8/20/2006 and was last updated on 12/16/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical0028965OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11518072404MEDICAIDOHIO
21518072404MEDICARE NSCOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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