Gina Maria Konicki, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC013177 Issued in PA

Practice address

406 Lenox Rd
Havertown, PA 19083-5505

Phone

(610) 505-5638

NPI assigned

Nov 2, 2023

Last updated

Nov 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gina Maria Daniels Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1639942451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LENOX RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835505",
            "telephone_number": "610-505-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 LENOX RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835505",
            "telephone_number": "610-505-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONICKI",
        "first_name": "GINA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC013177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "DANIELS",
            "middle_name": "MARIA",
            "credential": "MS, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Diane Marie Kline, OTR/L
• Kristen M Klingen, M.P.T.
• Valerie Klingerman, LPC
• KND Development 59 LLC
• Sarah Koch
• Kristianne Marie Kosanovich, MS, CCC-SLP
• Marc R Kossmann, PSY.D.
• Kristina Kotecha, LPC
• Dennis Martin Kraus, PTA
• Krista K Kraus

• Occupational Therapist in Havertown, PA
• Providers in Havertown, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.