Provider Demographics
NPI:1841414620
Name:KNOPF, CAROL (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:KNOPF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHAVIVA
Other - Middle Name:
Other - Last Name:KNOPF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5136 N DRAKE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5506
Mailing Address - Country:US
Mailing Address - Phone:773-968-8803
Mailing Address - Fax:
Practice Address - Street 1:5136 N DRAKE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5506
Practice Address - Country:US
Practice Address - Phone:773-968-8803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490108391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical