Healthcare Provider Details

I. General information

NPI: 1659290922
Provider Name (Legal Business Name): TY HUNTER KNOWLES LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E 9TH ST STE B
LAWRENCE KS
66044-2600
US

IV. Provider business mailing address

10 E 9TH ST STE B
LAWRENCE KS
66044-2600
US

V. Phone/Fax

Practice location:
  • Phone: 785-856-5592
  • Fax:
Mailing address:
  • Phone: 785-856-5592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14557
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: