Healthcare Provider Details

I. General information

NPI: 1164977377
Provider Name (Legal Business Name): JENNIFER A. KNAPP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7318 INTERNATIONAL DR STE B
HOLLAND OH
43528-9560
US

IV. Provider business mailing address

662 WHISPERLAKE RD
HOLLAND OH
43528-7878
US

V. Phone/Fax

Practice location:
  • Phone: 419-297-7547
  • Fax:
Mailing address:
  • Phone: 419-297-7547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberE.1300417
License Number StateOH

VIII. Authorized Official

Name: MRS. JENNIFER ANN KNAPP
Title or Position: COUNSELOR
Credential: LPCC
Phone: 419-344-3318