NPIMap

Individual provider Active NPI

Carol Knieriem, LICSW

  • Clinical Social Worker
  • Manchester, NH
National Provider Identifier
1851350268
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
138 Issued in NH
Practice address
2013 Elm St
Pastoral Counseling Services
Manchester, NH 03104-2528
Phone
(603) 627-2702
Fax
(603) 627-3643
NPI assigned
Mar 23, 2006
Last updated
Jul 15, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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 138 NH Primary

Addresses

Primary practice location

2013 Elm St
Pastoral Counseling Services
Manchester, NH 03104-2528

Mailing address

2013 Elm St
Pastoral Counseling Services
Manchester, NH 03104-2528
Phone (603) 627-2702

Other identifiers 5

IdentifierTypeStateIssuer
30421027MedicaidNH
1401353Y0NH01OtherNHANTHEM ACES #
100821OtherNHCIGNA BH PIN
P00014340OtherRR MEDICARE
387284OtherNHMVP PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
138NHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services Past Accepting new patients
Elliot Physicians Network Past Accepting new patients

Organizations & group practices 2

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1851350268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 ELM ST",
            "address_2": "PASTORAL COUNSELING SERVICES",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042528",
            "telephone_number": "603-627-2702",
            "fax_number": "603-627-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 ELM ST",
            "address_2": "PASTORAL COUNSELING SERVICES",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042528",
            "telephone_number": "603-627-2702",
            "fax_number": "603-627-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIERIEM",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30421027",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ACES #",
            "identifier": "1401353Y0NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BH PIN",
            "identifier": "100821",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00014340",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP PIN",
            "identifier": "387284",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.