Provider Demographics
NPI:1811177991
Name:KNUEPPEL, STEPHANIE (LPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KNUEPPEL
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 1:400 E GRAND AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-6200
Mailing Address - Country:US
Mailing Address - Phone:608-368-8087
Mailing Address - Fax:608-312-2061
Practice Address - Street 1:400 E GRAND AVE STE 308
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-6200
Practice Address - Country:US
Practice Address - Phone:608-368-8087
Practice Address - Fax:608-312-2061
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3803125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4372500Medicaid