Provider Demographics
NPI:1750651535
Name:KNAPP, LINDSAY EILEEN (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:EILEEN
Last Name:KNAPP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 E MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CENTREVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49032-8524
Mailing Address - Country:US
Mailing Address - Phone:269-467-1001
Mailing Address - Fax:269-467-3072
Practice Address - Street 1:677 E MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:CENTREVILLE
Practice Address - State:MI
Practice Address - Zip Code:49032-8524
Practice Address - Country:US
Practice Address - Phone:269-467-1001
Practice Address - Fax:269-467-3072
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010858751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1708146Medicaid