Provider Demographics
NPI:1104344951
Name:KNABE, MATTHEW ALAN (LPC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALAN
Last Name:KNABE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4278 BUNKER LN
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2819
Mailing Address - Country:US
Mailing Address - Phone:615-579-8316
Mailing Address - Fax:
Practice Address - Street 1:900 MULL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313
Practice Address - Country:US
Practice Address - Phone:800-621-5207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700632101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor