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General NPI Number Information
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NPI Number | 1467401919
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Entity Type | Individual
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Provider Name | TIM STUART KNAPPENBERGER ACSW, LISW
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 CLEVELAND AVE NW SUITE 300
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City | CANTON
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State | OH
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Zip | 44702-1700
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Country | US
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Telephone | 330-454-7066
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Fax |
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Provider Business Mailing Address
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Address Line | 6237 PALMER DR NW
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City | CANTON
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State | OH
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Zip | 44718-1053
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Country | US
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Telephone | 330-499-5170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0000495
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License Number State | OH
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