Individual provider Active NPI

Laurie Jo Knowlton, LISW-S, SAP

  • Clinical Social Worker
  • Fairview Park, OH
National Provider Identifier
1457458341
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I10196 Issued in OH
Practice address
20939 Lorain Rd
Suite 8
Fairview Park, OH 44126-2022
Phone
(440) 213-3623
Fax
(440) 331-2052
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2012

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 I10196 OH Primary

Addresses

Primary practice location

20939 Lorain Rd
Suite 8
Fairview Park, OH 44126-2022

Mailing address

20939 Lorain Rd
Suite 8
Fairview Park, OH 44126-2022
Phone (440) 213-3623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080311000247 OH Practitioner - Clinical Social Worker 9830274182 Practice locations: Fairview Park, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20939 Lorain Rd
Fairview Park, OH 44126-2022
Phone (440) 331-2010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I10196OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cunningham & Jordan Counseling Associates Clinical Past Accepting new patients

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1457458341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20939 LORAIN RD",
            "address_2": "SUITE 8",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262022",
            "telephone_number": "440-213-3623",
            "fax_number": "440-331-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20939 LORAIN RD",
            "address_2": "SUITE 8",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262022",
            "telephone_number": "440-213-3623",
            "fax_number": "440-331-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLTON",
        "first_name": "LAURIE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LISW-S, SAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I10196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

Verify at the official NPI Registry.