Provider Demographics
NPI:1861037756
Name:KNAUER, ERIN MICHELLE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MICHELLE
Last Name:KNAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SW 5THST
Mailing Address - Street 2:
Mailing Address - City:GREEENFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:50849
Mailing Address - Country:US
Mailing Address - Phone:641-745-9530
Mailing Address - Fax:
Practice Address - Street 1:1111 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1001
Practice Address - Country:US
Practice Address - Phone:641-782-3528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077722101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health