Heather Knickerbocker, LCSW

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Practice address

6 Danforth Dr
Easton, PA 18045-7820

Phone

(610) 555-5550

NPI assigned

Nov 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1295443620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 DANFORTH DR",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180457820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DANFORTH DR",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180457820",
            "telephone_number": "610-555-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "HEATHER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Klembara, MPT
• Michael Klotz
• Hannah Katherine Kmet
• Rachel Knauss, DDS
• Angelina Marie Knerr, PTA
• Nora Ko, MD
• Amanda Koch
• Jessica Koch, CRNP
• David Paul Koehler, RPH
• Paige Kogelman

• Adolescent and Children Mental Health Clinic/Center in Easton, PA
• Providers in Easton, PA by specialty
• Adolescent and Children Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.