Provider Demographics
NPI:1053430421
Name:KNIPE, KYLE (LICSW)
Entity type:Individual
Prefix:MS
First Name:KYLE
Middle Name:
Last Name:KNIPE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FOWLERS CT
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4608
Mailing Address - Country:US
Mailing Address - Phone:603-474-0996
Mailing Address - Fax:
Practice Address - Street 1:11 FOWLERS CT
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4608
Practice Address - Country:US
Practice Address - Phone:603-474-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10273401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical