Organization Active NPI

Dan a Kniffen LCSW LLC

  • Mental Health Counselor
  • Henrico, VA
National Provider Identifier
1417406224
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0904000931 Issued in VA
Legal business name
DAN A KNIFFEN LCSW LLC
Practice address
4100 East Parham Road
Suite B
Henrico, VA 23228
Phone
(804) 755-7323
Fax
(804) 755-1215
NPI assigned
Sep 22, 2016
Last updated
Sep 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Authorized official

Name
Dan A Kniffen, LCSWNPI 1336179266
Title
President
Phone
(804) 755-7323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0904000931 VA Primary

Addresses

Primary practice location

4100 East Parham Road
Suite B
Henrico, VA 23228

Mailing address

4100 East Parham Road
Suite B
Henrico, VA 23228
Phone (804) 755-7323

Other identifiers 1

IdentifierTypeStateIssuer
8909920MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170808002337 VA Part B Supplier - Clinic/Group Practice 4880963537 Receives reassigned benefits from 1 practitioner
Practice locations: Henrico, VA

National Provider Directory

National Provider Directory

Locations

4100 E Parham Rd
Ste B
Richmond, VA 23228
Phone (804) 755-7323

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1417406224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EAST PARHAM ROAD",
            "address_2": "SUITE B",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "23228",
            "telephone_number": "804-755-7323",
            "fax_number": "804-755-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 EAST PARHAM ROAD",
            "address_2": "SUITE B",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "23228",
            "telephone_number": "804-755-7323",
            "fax_number": "804-755-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN A KNIFFEN LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "KNIFFEN",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-755-7323",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904000931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909920",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.