Provider Demographics
NPI:1396879458
Name:KNAPP, KENYON CHRISTIAN SR (LPC, NCC, CPCS)
Entity type:Individual
Prefix:DR
First Name:KENYON
Middle Name:CHRISTIAN
Last Name:KNAPP
Suffix:SR
Gender:M
Credentials:LPC, NCC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3457 SAMANTHA DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4078
Mailing Address - Country:US
Mailing Address - Phone:678-547-6012
Mailing Address - Fax:678-547-6008
Practice Address - Street 1:3001 MERCER UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4115
Practice Address - Country:US
Practice Address - Phone:678-547-6012
Practice Address - Fax:678-547-6008
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5962101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional