Individual provider Active NPI

Rosa Haydee Knowlton, LMSW

  • Clinical Social Worker
  • Lawrence, KS
National Provider Identifier
1053917153
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16054 Issued in KS
Practice address
3320 Peterson Rd Ste 104
Lawrence, KS 66049-1739
Phone
(785) 371-1414
NPI assigned
Dec 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16054 KS Primary

Addresses

Primary practice location

3320 Peterson Rd Ste 104
Lawrence, KS 66049-1739

Mailing address

3320 Peterson Rd Ste 104
Lawrence, KS 66049-1739
Phone (785) 371-1414

Other identifiers 2

IdentifierTypeStateIssuer
11098OtherKSSOCIAL WORK
11098OtherSOCIAL WORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16054KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Psychological Services LLC CurrentSince Dec 29, 2024 Accepting new patients

Locations

3320 Peterson Rd
Ste 104
Lawrence, KS 66049
Phone (785) 371-1414

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1053917153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 PETERSON RD STE 104",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660491739",
            "telephone_number": "785-371-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 PETERSON RD STE 104",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660491739",
            "telephone_number": "785-371-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLTON",
        "first_name": "ROSA",
        "middle_name": "HAYDEE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-05",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "16054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK",
            "identifier": "11098",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK",
            "identifier": "11098",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.