Provider Demographics
NPI:1588930341
Name:KNAUER, STEFFANY
Entity type:Individual
Prefix:
First Name:STEFFANY
Middle Name:
Last Name:KNAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 POPLAR LEVEL RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-1527
Mailing Address - Country:US
Mailing Address - Phone:502-805-1121
Mailing Address - Fax:
Practice Address - Street 1:4211 POPLAR LEVEL RD
Practice Address - Street 2:STE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-1527
Practice Address - Country:US
Practice Address - Phone:502-805-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5740104100000X
KY2540181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker