Provider Demographics
NPI:1417378852
Name:KNEPP, ANDRE THOMAS (LMHC)
Entity Type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:THOMAS
Last Name:KNEPP
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IN
Mailing Address - Zip Code:47558-0035
Mailing Address - Country:US
Mailing Address - Phone:812-486-2333
Mailing Address - Fax:812-486-3337
Practice Address - Street 1:542 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IN
Practice Address - Zip Code:47558-5745
Practice Address - Country:US
Practice Address - Phone:812-486-2333
Practice Address - Fax:812-486-3337
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002558A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health