Provider Demographics
NPI:1578747937
Name:KNAPP, PENELOPE M (PLMHP, PLADC)
Entity Type:Individual
Prefix:
First Name:PENELOPE
Middle Name:M
Last Name:KNAPP
Suffix:
Gender:F
Credentials:PLMHP, PLADC
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 129
Mailing Address - Street 2:101 WEST 8TH, SUITE D
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-0129
Mailing Address - Country:US
Mailing Address - Phone:308-324-0222
Mailing Address - Fax:308-324-0225
Practice Address - Street 1:101 W 8TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1971
Practice Address - Country:US
Practice Address - Phone:308-324-0222
Practice Address - Fax:308-324-0225
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-657101YA0400X
NE8155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE98379OtherBCBS
NE10025338800Medicaid