Provider Demographics
NPI:1164977377
Name:JENNIFER A. KNAPP, LLC
Entity Type:Organization
Organization Name:JENNIFER A. KNAPP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:419-344-3318
Mailing Address - Street 1:1453 MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9540
Mailing Address - Country:US
Mailing Address - Phone:419-297-7547
Mailing Address - Fax:
Practice Address - Street 1:1070 COMMERCE DR
Practice Address - Street 2:BUILDING ONE, SUITE 204
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5236
Practice Address - Country:US
Practice Address - Phone:419-344-3318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1300417261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)