Provider Demographics
NPI:1730678350
Name:KNAPP PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:KNAPP PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:734-564-7169
Mailing Address - Street 1:1100 CORPORATE OFFICE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-5002
Mailing Address - Country:US
Mailing Address - Phone:734-564-7169
Mailing Address - Fax:734-780-3005
Practice Address - Street 1:1100 CORPORATE OFFICE DR STE 300
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-5002
Practice Address - Country:US
Practice Address - Phone:734-564-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015282103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty