Healthcare Provider Details

I. General information

NPI: 1417681982
Provider Name (Legal Business Name): WHOLISTIC PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 5TH AVE RM 905
NEW YORK NY
10016-6682
US

IV. Provider business mailing address

611 MISSOURI RD
VENICE FL
34293-6447
US

V. Phone/Fax

Practice location:
  • Phone: 216-536-6212
  • Fax: 917-508-4842
Mailing address:
  • Phone: 216-536-6212
  • Fax: 917-508-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MICHELLE MARIE KNAPP
Title or Position: OWNER, CLINICIAN
Credential: PMHNP-BC
Phone: 216-536-6212