Individual provider Active NPI

Kaitlen Knowles, LCSW

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1659963957
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087821 Issued in NY
Practice address
3300 Dewey Ave
Rochester, NY 14616-3741
Phone
(585) 281-5787
NPI assigned
Feb 8, 2021
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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 087821 NY Primary

Addresses

Primary practice location

3300 Dewey Ave
Rochester, NY 14616-3741

Mailing address

920 Winton Rd S Ste 204
Rochester, NY 14618-1634
Phone (585) 734-8713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240628000486 NY Practitioner - Clinical Social Worker 9234673401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Villa of HopeGroup PAC ID 0840580387, 6 clinicians

Practice addresses (Care Compare)

247 N Goodman St
Rochester, NY 14607-1168
Phone (585) 627-5892

3300 Dewey Ave
Rochester, NY 14616-3741
Phone 5858651550322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Villa of Hope CurrentSince Apr 19, 2024 Accepting new patients

Locations

247 N Goodman St
Rochester, NY 14607
Phone (585) 627-5892

3300 Dewey Ave
Rochester, NY 14616
Phone (585) 865-1550

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1659963957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 WINTON RD S STE 204",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146181634",
            "telephone_number": "585-734-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 DEWEY AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146163741",
            "telephone_number": "585-281-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "KAITLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.