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KENNETH T CAPPUCCIO LLC
NPI 1023295367
Social Worker - Clinical in Myrtle Beach, SC

Active since January 29, 2008
2195 HAYSTACK WAY, MYRTLE BEACH, SC 29579(908) 447-2913 Get Directions Write a Review

NPPES record last updated: September 27, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kenneth T Cappuccio Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH T CAPPUCCIO LLC (NPI 1023295367) is a healthcare organization registered as a clinical in Myrtle Beach, South Carolina and active in the NPI registry since January 2008. The organization lists Kenneth Thomas Cappuccio, President, as its authorized official.

NPPES Registry Identity

NPI1023295367
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameKENNETH T CAPPUCCIO LLC
Location Address2195 HAYSTACK WAYMyrtle Beach, SC 29579-3276
Mailing Address2195 Haystack WayMyrtle Beach, SC 29579-3276 · (908) 447-2913
Phone(908) 447-2913
Organization SubpartNo
Authorized OfficialKenneth Thomas CappuccioPresident · (908) 447-2913
Enumeration DateJanuary 29, 2008
Last NPPES UpdateSeptember 27, 2022
NPPES CertifiedSeptember 27, 2022
✔ NPI 1023295367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NJ · 44SC04533100
Definition
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.
2195 HAYSTACK WAY, Myrtle Beach, SC 29579
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth T Cappuccio Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateSouth CarolinaEnrollment IDO20220304000889Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kenneth T Cappuccio LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kenneth Cappuccio, LCSW
Clinical Social Worker
NPI 1073674776
2195 HAYSTACK WAY
Myrtle Beach, SC 29579
(908) 447-2913
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth T Cappuccio LLC's NPI number?

The NPI number for Kenneth T Cappuccio LLC is 1023295367. It was assigned to this organization in the NPPES registry on January 29, 2008.

Where is Kenneth T Cappuccio LLC located?

Kenneth T Cappuccio LLC is located at 2195 Haystack Way, Myrtle Beach, SC 29579. The listed phone number is (908) 447-2913.

What is Kenneth T Cappuccio LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kenneth T Cappuccio LLC enrolled in Medicare?

Yes. Kenneth T Cappuccio LLC is registered in the Medicare PECOS enrollment system.

When is Kenneth T Cappuccio LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (South Carolina, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Kenneth T Cappuccio LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Kenneth T Cappuccio LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kenneth T Cappuccio LLC accept?

Health plans from BlueCross BlueShield of South Carolina list Kenneth T Cappuccio LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenneth T Cappuccio LLC was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.