Provider Demographics
NPI:1578823290
Name:KNAUSS, DANIEL PAUL CHARLES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL CHARLES
Last Name:KNAUSS
Suffix:
Gender:M
Credentials:PSYD
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 962
Mailing Address - Street 2:25 MAIN ST.
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262-0101
Mailing Address - Country:US
Mailing Address - Phone:413-931-5304
Mailing Address - Fax:413-298-4020
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262-9701
Practice Address - Country:US
Practice Address - Phone:413-931-5304
Practice Address - Fax:413-298-4020
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10572103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist