Kimarie Boerger Knowles, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078142 Issued in NY

Practice address

131 7TH Ave # 356
New York, NY 10011-1802

Phone

(917) 701-4687

NPI assigned

Dec 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Illumine Counseling LCSW PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1639875511
  NPD

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124200191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 7TH AVE # 356",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111802",
            "telephone_number": "917-701-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 7TH AVE # 356",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111802",
            "telephone_number": "917-701-4687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 Willow Ter",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070302813",
            "country_code": "US",
            "telephone_number": "917-701-4687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19 W 34th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100013006",
            "country_code": "US",
            "telephone_number": "917-701-4687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "KIMARIE",
        "middle_name": "BOERGER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05603400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW023438",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Knowing Physical Therapy PC
• Knowing Wellness, LLC
• Knowledge Health Medical Services PC
• Daniel Knowles, M.D.
• Kelley Knowles
• Stephen Knowles, STUDENT, HEALTH CARE
• Ebony Knowlin, LCSW
• Donna C Knowlton, DDS
• Justin A Knox
• Mary E. Knox

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.