Provider Demographics
NPI:1902129257
Name:KNOCHEL, LINDSEY RAE (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:RAE
Last Name:KNOCHEL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:MO
Mailing Address - Zip Code:63461-1927
Mailing Address - Country:US
Mailing Address - Phone:217-592-0432
Mailing Address - Fax:217-592-0391
Practice Address - Street 1:205 S 24TH ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-4446
Practice Address - Country:US
Practice Address - Phone:217-592-0432
Practice Address - Fax:217-592-0391
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150011922104100000X
IL149.0159761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker