Provider Demographics
NPI:1114310869
Name:KNEIB, DANIELLE LEANN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LEANN
Last Name:KNEIB
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:MO
Mailing Address - Zip Code:64485-1312
Mailing Address - Country:US
Mailing Address - Phone:816-617-3098
Mailing Address - Fax:
Practice Address - Street 1:905 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:MO
Practice Address - Zip Code:64485-1312
Practice Address - Country:US
Practice Address - Phone:816-617-3098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20150042191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO142260056Medicare PIN