Individual provider Active NPI

Marcy Kniffin, LCSW

  • Clinical Social Worker
  • Brewster, NY
National Provider Identifier
1154416832
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R041537-1 Issued in NY
Practice address
1591 Route 22
C/O Wholistic Physical Therapy
Brewster, NY 10509-4026
Phone
(845) 309-4571
Fax
(845) 940-1051
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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 R041537-1 NY Primary

Addresses

Primary practice location

1591 Route 22
C/O Wholistic Physical Therapy
Brewster, NY 10509-4026

Mailing address

18 North St
Patterson, NY 12563-2710
Phone (845) 309-4571

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
R041537-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Route 22 Medical PC Past Accepting new patients
Wholistic Physical Therapy, PC PastSince Jul 3, 2002 Accepting new patients

Organizations & group practices 2

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1154416832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 NORTH ST",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "125632710",
            "telephone_number": "845-309-4571",
            "fax_number": "845-223-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 ROUTE 22",
            "address_2": "C/O WHOLISTIC PHYSICAL THERAPY",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094026",
            "telephone_number": "845-309-4571",
            "fax_number": "845-940-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIFFIN",
        "first_name": "MARCY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R041537-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.