Individual provider Active NPI

Judith Alice Knoop, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1881765683
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW012782 Issued in PA
Practice address
1211 Chestnut St Ste 605
Philadelphia, PA 19107-4117
Phone
(215) 525-8657
Fax
(215) 988-9062
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW012782 PA Primary
Clinical Social Worker 1041C0700X LCSW-12586 AZ

Addresses

Primary practice location

1211 Chestnut St Ste 605
Philadelphia, PA 19107-4117

Mailing address

1233 Locust St 3Rd FL
Philadelphia, PA 19107-5400
Phone (215) 985-4448

Other identifiers 1

IdentifierTypeStateIssuer
1035172530001MedicaidPA

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
LCSW-12586AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Landstuhl Regional Medical Center 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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1881765683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 LOCUST ST 3RD FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075400",
            "telephone_number": "215-985-4448",
            "fax_number": "215-985-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 CHESTNUT ST STE 605",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074117",
            "telephone_number": "215-525-8657",
            "fax_number": "215-988-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOOP",
        "first_name": "JUDITH",
        "middle_name": "ALICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012782",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-12586",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035172530001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.