Provider Demographics
NPI:1891915104
Name:KNAPP, KELLY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LONGVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE HIAWATHA
Mailing Address - State:NJ
Mailing Address - Zip Code:07034-1708
Mailing Address - Country:US
Mailing Address - Phone:973-541-1595
Mailing Address - Fax:
Practice Address - Street 1:80 W MAIN STREET
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945
Practice Address - Country:US
Practice Address - Phone:973-539-5624
Practice Address - Fax:973-539-5489
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00313000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional