Provider Demographics
NPI:1356434872
Name:KNAPP, MARY SUSAN (MSW, LISW, LLC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:SUSAN
Last Name:KNAPP
Suffix:
Gender:F
Credentials:MSW, LISW, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 45TH ST.
Mailing Address - Street 2:
Mailing Address - City:DES MOINES,
Mailing Address - State:IA
Mailing Address - Zip Code:50311
Mailing Address - Country:US
Mailing Address - Phone:515-277-6200
Mailing Address - Fax:515-274-4769
Practice Address - Street 1:6957 UNIVERSITY AVE.
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS,
Practice Address - State:IA
Practice Address - Zip Code:50311
Practice Address - Country:US
Practice Address - Phone:515-277-6200
Practice Address - Fax:515-274-1774
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA011861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical