Healthcare Provider Details

I. General information

NPI: 1679908586
Provider Name (Legal Business Name): CAROLINE KNAPP LMFT, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 CAMINO TORCIDO LOOP
SANTA FE NM
87507-4341
US

IV. Provider business mailing address

49 CAMINO TORCIDO LOOP
SANTA FE NM
87507-4341
US

V. Phone/Fax

Practice location:
  • Phone: 415-938-7528
  • Fax:
Mailing address:
  • Phone: 415-938-7528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number105656
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0212451
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: