Provider Demographics
NPI:1932988805
Name:KNEESSI, DONALD F JR (LGPC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:F
Last Name:KNEESSI
Suffix:JR
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 RITCHIE HWY STE F
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-6940
Mailing Address - Country:US
Mailing Address - Phone:410-777-3031
Mailing Address - Fax:
Practice Address - Street 1:8131 RITCHIE HWY STE F
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-6940
Practice Address - Country:US
Practice Address - Phone:410-777-3031
Practice Address - Fax:410-761-3777
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14099101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health