Kimberly Knickerbocker, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801101205 Issued in MI

Practice address

1570 Suncrest Dr
Lapeer, MI 48446-1154

Phone

(810) 667-0500

Fax

(810) 664-8728

NPI assigned

Jul 7, 2016

Last updated

Jul 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1558713164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ROLLING HILLS LN APT 2",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484464760",
            "telephone_number": "810-667-0500",
            "fax_number": "810-664-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 SUNCREST DR",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461154",
            "telephone_number": "810-667-0500",
            "fax_number": "810-664-8728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1134 S Linden Rd Ste 8",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323455",
            "country_code": "US",
            "telephone_number": "810-877-6343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "KIMBERLY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801101205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nickolas John Kipreos, RPH
• Katie Klein, PHARMD
• Laci Y Kline
• Emilee Knappen
• Knee and Orthopaedic Center of Lapeer PC
• David Kocenda, FNP-C
• Annabelle Konczal
• Cheri Koning, P.T.
• Sally Riyadh Konja
• Andrea E Kot

• Clinical Social Worker in Lapeer, MI
• Providers in Lapeer, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.