Provider Demographics
NPI:1124572656
Name:KNAPP, ANGELA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:PANCOAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2534 KIOWA TRL
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730-3007
Mailing Address - Country:US
Mailing Address - Phone:321-305-1320
Mailing Address - Fax:
Practice Address - Street 1:2534 KIOWA TRL
Practice Address - Street 2:
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730-3007
Practice Address - Country:US
Practice Address - Phone:321-305-1320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-13
Last Update Date:2016-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 98621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical