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NPI Code Detail

MEDICARE: NICOLE KRISTINE KNEPPER LCPC

MEDICARE:   NICOLE KRISTINE KNEPPER  LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor180.004778IL

General Provider Information

NPI Number : 1194092635
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE KRISTINE KNEPPER LCPC
Provider Business Mailing Address
First Line : 2405 TWIN FOUNTAIN CT
Second Line :
City : PLAINFIELD
State : IL
Zip : 60586-6397
Country : US
Telephone Number : 773-655-1198
Fax Number :
Provider Business Practice Location Address
First Line : 123 W WASHINGTON ST
Second Line : SUITE 340
City : OSWEGO
State : IL
Zip : 60543-8214
Country : US
Telephone Number : 630-383-7006
Fax Number : 630-383-7006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2011
Last Update Date : 04/25/2017

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Directions to “ NICOLE KRISTINE KNEPPER LCPC” Practice Location

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