Provider Demographics
NPI:1164943122
Name:KNOEDLER, ALAINA C (LPC)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:C
Last Name:KNOEDLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68887 BLANCHARD ST
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-9244
Mailing Address - Country:US
Mailing Address - Phone:630-200-0003
Mailing Address - Fax:
Practice Address - Street 1:650 TRADE CENTRE WAY
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-0411
Practice Address - Country:US
Practice Address - Phone:833-586-1113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
MI6401223793101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional