Provider Demographics
NPI:1063518330
Name:KNAPP, DAVID R (LCSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:KNAPP
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16603-0228
Mailing Address - Country:US
Mailing Address - Phone:814-944-9534
Mailing Address - Fax:814-944-0919
Practice Address - Street 1:615 HOWARD AVENUE
Practice Address - Street 2:SUITE 214
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601
Practice Address - Country:US
Practice Address - Phone:814-944-9534
Practice Address - Fax:814-944-0919
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW004596L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA302772OtherUNIVERSITY OF PA
PA990154OtherBLUE CROSS BLUE SHIELD
PA302772OtherUNIVERSITY OF PA