Healthcare Provider Details

I. General information

NPI: 1841460201
Provider Name (Legal Business Name): JASON A KNIOLA MS, NCC, LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2008
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 DIGBY RD
LAFAYETTE IN
47905-1150
US

IV. Provider business mailing address

326 E US HIGHWAY 30
SCHERERVILLE IN
46375-2654
US

V. Phone/Fax

Practice location:
  • Phone: 765-491-7760
  • Fax:
Mailing address:
  • Phone: 765-491-7760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39001855A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: