Individual provider Active NPI

Kim Elaine Knoeller, LCSW

  • Clinical Social Worker
  • Sanford, NC
National Provider Identifier
1972847366
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008068 Issued in NC
Practice address
49 Lookout PT
Sanford, NC 27332-9666
Phone
(843) 455-2736
Fax
(910) 516-1370
NPI assigned
Nov 26, 2012
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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 C008068 NC Primary
Counselor 101Y00000X C008068 NC

Addresses

Primary practice location

49 Lookout PT
Sanford, NC 27332-9666

Mailing address

49 Lookout PT
Sanford, NC 27332-9666
Phone (843) 455-2736

Other names 1

  • Kim Elaine Winn Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Connections Clinical Group, PLLC Counselor CurrentSince Mar 20, 2025 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, 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": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1972847366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 LOOKOUT PT",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273329666",
            "telephone_number": "843-455-2736",
            "fax_number": "910-516-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 LOOKOUT PT",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273329666",
            "telephone_number": "843-455-2736",
            "fax_number": "910-516-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOELLER",
        "first_name": "KIM",
        "middle_name": "ELAINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008068",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "C008068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "WINN",
            "middle_name": "ELAINE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.