Provider Demographics
NPI:1568919090
Name:KNAPP, CAROLYN JO (MA LPC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JO
Last Name:KNAPP
Suffix:
Gender:F
Credentials:MA LPC
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 392
Mailing Address - Street 2:
Mailing Address - City:ALDERSON
Mailing Address - State:WV
Mailing Address - Zip Code:24910-0392
Mailing Address - Country:US
Mailing Address - Phone:304-661-7532
Mailing Address - Fax:
Practice Address - Street 1:200 MONROE STREET N
Practice Address - Street 2:
Practice Address - City:ALDERSON
Practice Address - State:WV
Practice Address - Zip Code:24910
Practice Address - Country:US
Practice Address - Phone:304-661-7532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV1519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional