Healthcare Provider Details

I. General information

NPI: 1407524366
Provider Name (Legal Business Name): AMANDA KNAPPER M.ED, LPCC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 UNIVERSITY DR N
FARGO ND
58102-4006
US

IV. Provider business mailing address

2312 42ND ST S
MOORHEAD MN
56560-8218
US

V. Phone/Fax

Practice location:
  • Phone: 701-543-6313
  • Fax: 701-935-7176
Mailing address:
  • Phone: 701-543-6313
  • Fax: 701-935-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1153-9-1-21-631
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4284
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1153-9-1-21A
License Number StateND
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1153-9-1-21A
License Number StateND
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1153-9-1-21A
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: