Healthcare Provider Details

I. General information

NPI: 1033034251
Provider Name (Legal Business Name): TORI ROSE KNUEPPEL LPC-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N MAYFAIR RD STE 400
WAUWATOSA WI
53226-1306
US

IV. Provider business mailing address

1932 E KENILWORTH PL APT 15
MILWAUKEE WI
53202-1177
US

V. Phone/Fax

Practice location:
  • Phone: 414-939-9390
  • Fax: 414-939-9383
Mailing address:
  • Phone: 414-630-6389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: