Healthcare Provider Details

I. General information

NPI: 1497026421
Provider Name (Legal Business Name): SUZANNE MILLAR KNAPP LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2012
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 LANDMAN DR NE
ALBUQUERQUE NM
87112-6024
US

IV. Provider business mailing address

1116 LANDMAN DR NE
ALBUQUERQUE NM
87112-6024
US

V. Phone/Fax

Practice location:
  • Phone: 239-910-2205
  • Fax:
Mailing address:
  • Phone: 239-910-2205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29322
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200002715
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12957807
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number082213
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114683
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2022-0126
License Number StateNM
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2204055
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: