Provider Demographics
NPI:1386803625
Name:KNEIP, BROOKLYN R (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BROOKLYN
Middle Name:R
Last Name:KNEIP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2920 N GREEN VALLEY PKWY
Mailing Address - Street 2:BLDG 3 SUITE 312
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0406
Mailing Address - Country:US
Mailing Address - Phone:702-253-1173
Mailing Address - Fax:702-253-1468
Practice Address - Street 1:2920 N GREEN VALLEY PKWY
Practice Address - Street 2:BLDG 3 SUITE 312
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0406
Practice Address - Country:US
Practice Address - Phone:702-253-1173
Practice Address - Fax:702-253-1468
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5250-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical