Individual provider Active NPI

Kathryn Kniele, PH.D.

  • Clinical Psychologist
  • Charleston, SC
National Provider Identifier
1356369664
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1026 Issued in SC
Practice address
1744 Sam Rittenberg Blvd
Suite A3
Charleston, SC 29407-4935
Phone
(843) 278-7716
Fax
(843) 278-7716
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1026 SC Primary
Clinical Neuropsychologist 103G00000X 1026 SC

Addresses

Primary practice location

1744 Sam Rittenberg Blvd
Suite A3
Charleston, SC 29407-4935

Mailing address

1744 Sam Rittenberg Blvd
Suite A3
Charleston, SC 29407-4935
Phone (843) 278-7716

Other identifiers 1

IdentifierTypeStateIssuer
PS0426MedicaidSC

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1356369664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 SAM RITTENBERG BLVD",
            "address_2": "SUITE A3",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074935",
            "telephone_number": "843-278-7716",
            "fax_number": "843-278-7716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 SAM RITTENBERG BLVD",
            "address_2": "SUITE A3",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074935",
            "telephone_number": "843-278-7716",
            "fax_number": "843-278-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIELE",
        "first_name": "KATHRYN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1026",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "SC",
            "license": "1026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0426",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.