MEDICARE: STEPHANIE KNIPPER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1285385278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE KNIPPER

Provider Business Mailing Address
First Line	:	1480 SHIREPEAK WAY
Second Line	:
City	:	INDEPENDENCE
State	:	KY
Zip	:	41051-7425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 ALEXANDRIA PIKE STE 220
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2169
Country	:	US
Telephone Number	:	513-488-7161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2022
Last Update Date	:	01/12/2022

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Directions to “ STEPHANIE KNIPPER ” Practice Location

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