Elisabeth Kornblee, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106871 Issued in MA

Practice address

151 Taber Ave Apt 4
Providence, RI 02906

Phone

(401) 751-5120

NPI assigned

Dec 29, 2005

Last updated

Aug 27, 2018By 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

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1952388068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 TABER AVE APT 4",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063358",
            "telephone_number": "401-751-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 TABER AVE APT 4",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-751-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLEE",
        "first_name": "ELISABETH",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Stephen Kopecky, MD
• Kerryann Elizabeth Koper
• Matthew Kopp, MD
• Nicole Korbly, MD
• Gideon Koren, M.D.
• Kenneth S Korr, MD
• Inga Korsgaard, PHD
• Laura Elizabeth Korthauer Gilmour, PHD
• Molyneat Kosal
• Chirene Kosseifi

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.