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KENNETH JAMES HOLT LISW-S, LICDC
NPI 1174974117
Social Worker - Clinical in Mentor, OH

Active since June 30, 2016PECOS Enrolled
7232 JUSTIN WAY, MENTOR, OH 44060(440) 578-8200 Get Directions Write a Review

NPPES record last updated: March 28, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 28, 2021, Feb 16, 2021, Nov 27, 2018 and 1 more (4 updates tracked since 2016).

About Kenneth James Holt Lisw-s, Licdc NPPES

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

KENNETH JAMES HOLT LISW-S, LICDC (NPI 1174974117) is an individual clinical provider in Mentor, Ohio, licensed in Ohio (I.1801239) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174974117
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameKENNETH JAMES HOLTCredential: LISW-S, LICDC
Location Address7232 JUSTIN WAYMentor, OH 44060-4881
Mailing Address7232 Justin WayMentor, OH 44060-4881 · (440) 578-8200
Phone(440) 578-8200
Sole ProprietorNo
Enumeration DateJune 30, 2016
Last NPPES UpdateMarch 28, 20214 updates tracked since enumeration
NPPES CertifiedMarch 28, 2021
✔ NPI 1174974117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OH · I.1801239
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.
Also ListedSocial WorkerTaxonomy 104100000X · License S.1600314 (OH)
7232 JUSTIN WAY, Mentor, OH 44060
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Other Identifiers 1

Medicaid0266919OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth James Holt Lisw-s, Licdc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kenneth Holt reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Signature Health, Inc
2.6 mi
Mental Health (Including Community Mental Health Center)
38876 MENTOR AVE
Willoughby, OH 44094
  • Reassigned Medicare billing, Ohio enrollment
  • 342 clinicians in this Medicare group
NPI 1477575348 (440) 953-9999
Grow Healthcare Group PA
1,098 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Ohio enrollment
  • 725 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.34 – $166.65
Typical copayment $0.00 (range $13.58 – $41.66)
Most-billed visit code NA
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TIFFANY JONES M.D.
Psychiatry & Neurology (Psychiatry)
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
ASHLEY NICHOLE FOCHT
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
MRS. FATIMAAH D FULLILOVE LSW, LICDC
Social Worker (Clinical)
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
THERESA GILL LPCC
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
JAMIE GAMBRELL
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
CLOTILDA J RAYMOND
Social Worker
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
BRENDA BERRY SAMPLE
Case Manager/Care Coordinator
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
KIMBERLEE BIZUP LPCC-S
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200

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 Holt's NPI number?

The NPI number for Kenneth Holt is 1174974117. It was assigned to this individual provider in the NPPES registry on June 30, 2016.

Where is Kenneth Holt located?

Kenneth Holt practices at 7232 Justin Way, Mentor, OH 44060. The listed phone number is (440) 578-8200.

What is Kenneth Holt's specialty?

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

Is Kenneth Holt enrolled in Medicare?

Yes. Kenneth Holt is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kenneth Holt's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Holt reassigns Medicare benefits to 2 organizations: Signature Health, Inc (Willoughby, OH) and Grow Healthcare Group PA (Miami, FL). Each 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 Kenneth Holt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kenneth Holt accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, Molina Healthcare and UnitedHealthcare list Kenneth Holt 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 Holt was last updated on March 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.