Organization
KSK HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE L KIDD LPCC/PCC (MANAGER/CEO)
(440) 481-3055
Entity
Organization
Contact information
Practice address
6929 W 130TH ST, SUITE 503, PARMA HEIGHTS, OH 44130-7895
(440) 481-3055
(440) 481-3222
Mailing address
6929 W 130TH ST, SUITE 503, PARMA HEIGHTS, OH 44130-7895
(440) 481-3055
(440) 481-3222
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
E0004052
OH
101YP2500X
Professional Counselor
E0007819
OH
101YP2500X
Professional Counselor
E0900389
OH
103TC0700X
Clinical Psychologist
6890
OH
1041C0700X
Clinical Social Worker
I0007634
OH
2084P0800X
Psychiatry Physician
Primary
35060650
OH
2084P0800X
Psychiatry Physician
35099315
OH
2084P0804X
Child & Adolescent Psychiatry Physician
35060650
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051324
—
OH
05
—
0084596
—
OH
01
—
11744590
PROVIDER CAQH #
OH
01
—
11753827
PROVIDER CAQH #
OH
01
—
12634224
PROVIDER CAQH #
OH
01
—
12638930
PROVIDER CAQH #
OH
01
—
2908413
PROVIDER UHC/UBH ID#
OH
05
—
2967384
—
OH
01
—
3349058
UHC/UBH PROVIDER ID
OH
01
—
393335
PROVIDER MHN (HEALTHNET) ID#
OH
01
—
587502
PROVIDER VO ID#
OH
01
—
687211
VO GROUP PROVIDER ID#
OH
Enumeration date
04/09/2011
Last updated
12/12/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us