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General NPI Number Information
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NPI Number | 1902129257
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Entity Type | Individual
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Provider Name | LINDSEY RAE KNOCHEL MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 205 S 24TH ST
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City | QUINCY
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State | IL
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Zip | 62301-4446
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Country | US
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Telephone | 217-592-0432
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Fax | 217-592-0391
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Provider Business Mailing Address
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Address Line | 922 S MAIN ST
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City | PALMYRA
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State | MO
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Zip | 63461-1927
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Country | US
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Telephone | 217-592-0432
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Fax | 217-592-0391
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150011922
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.015976
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License Number State | IL
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