Provider Demographics
NPI:1083145361
Name:KNACK, KEVIN LEE
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:LEE
Last Name:KNACK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 E. SECOND ST. SUITE 326
Mailing Address - Street 2:ACUMEN COUNSELING
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987
Mailing Address - Country:US
Mailing Address - Phone:855-855-6776
Mailing Address - Fax:855-211-8645
Practice Address - Street 1:902 E. SECOND ST. SUITE 326
Practice Address - Street 2:ACUMEN COUNSELING
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987
Practice Address - Country:US
Practice Address - Phone:608-386-4575
Practice Address - Fax:855-211-8645
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health