Active NPI
Camille Koenig, LCSW
- Clinical Social Worker
- Ardmore, PA
National Provider Identifier
1174292890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW021984
- Practice address
- 27 West Athens Avenue
Ardmore, PA 19003 - Phone
- (267) 271-0661
- NPI assigned
- Sep 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW021984 | PA | Primary |
Addresses
Primary practice location
27 West Athens Avenue
Ardmore, PA 19003
Mailing address
1136 N 4TH Street
Apt 2
Philadelphia, PA 19123
Phone (267) 271-0661
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
| License | State | Type | Specialty |
|---|---|---|---|
| CW021984 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630972800000",
"number": "1174292890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1136 N 4TH STREET",
"address_2": "APT 2",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19123",
"telephone_number": "267-271-0661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 WEST ATHENS AVENUE",
"city": "ARDMORE",
"state": "PA",
"postal_code": "19003",
"telephone_number": "267-271-0661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "CAMILLE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-07",
"last_updated": "2021-09-07",
"certification_date": "2021-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW021984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.