Kenneth T Cappuccio Llc - Medicare Mental Health Clinic in Myrtle Beach, SC

Kenneth T Cappuccio Llc is a medicare enrolled mental health clinic (Social Worker - Clinical) in Myrtle Beach, South Carolina. The current practice location for Kenneth T Cappuccio Llc is 2195 Haystack Way, Myrtle Beach, South Carolina. For appointments, you can reach them via phone at (908) 447-2913. The mailing address for Kenneth T Cappuccio Llc is 2195 Haystack Way, Myrtle Beach, South Carolina and phone number is (908) 447-2913.

Kenneth T Cappuccio Llc is licensed to practice in New Jersey (license number 44SC04533100). The clinic also participates in the medicare program and its NPI number is 1023295367. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (908) 447-2913.

Contact Information

Kenneth T Cappuccio Llc
2195 Haystack Way
Myrtle Beach
SC 29579-3276
(908) 447-2913
Not Available

Mental Health Clinic Profile

Full NameKenneth T Cappuccio Llc
SpecialitySocial Worker
Location2195 Haystack Way, Myrtle Beach, South Carolina
Authorized Official Name and PositionKenneth Thomas Cappuccio (PRESIDENT)
Authorized Official Contact9084472913
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kenneth T Cappuccio Llc
2195 Haystack Way
Myrtle Beach
SC 29579-3276

Ph: (908) 447-2913
Kenneth T Cappuccio Llc
2195 Haystack Way
Myrtle Beach
SC 29579-3276

Ph: (908) 447-2913

NPI Details:

NPI Number1023295367
Provider Enumeration Date01/29/2008
Last Update Date09/27/2022
Certification Date09/27/2022

Medicare PECOS Information:

Medicare PECOS PAC ID3577693522
Medicare Enrollment IDO20220304000889

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Medical Identifiers

Medical identifiers for Kenneth T Cappuccio Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023295367NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 44SC04533100 (New Jersey)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Kenneth T Cappuccio Llc acts as a billing entity for following providers:
Provider NameKenneth T Cappuccio
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1073674776
PECOS PAC ID: 2264479559
Enrollment ID: I20220303001807

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