Basic Information
| Provider Information | |||||||||
| NPI: | 1407882244 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNAPP | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | EUGENE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | E10339 STATE ROAD 82 | ||||||||
| Address2: | |||||||||
| City: | LA FARGE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546398039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6086254522 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2600 STATE RD | ||||||||
| Address2: | |||||||||
| City: | LA CROSSE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546016157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008728662 | ||||||||
| FaxNumber: | 6087840262 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 6557-123 | WI | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.