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NPI Code Detail

MEDICARE: DR. KENYON CHRISTIAN KNAPP SR. LPC, NCC, CPCS

MEDICARE: DR. KENYON CHRISTIAN KNAPP SR. LPC, NCC, CPCS
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 Counselor5962GA

General Provider Information

NPI Number : 1396879458
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENYON CHRISTIAN KNAPP SR. LPC, NCC, CPCS
Provider Business Mailing Address
First Line : 3457 SAMANTHA DR
Second Line :
City : BUFORD
State : GA
Zip : 30519-4078
Country : US
Telephone Number : 678-547-6012
Fax Number : 678-547-6008
Provider Business Practice Location Address
First Line : 3001 MERCER UNIVERSITY DR
Second Line :
City : ATLANTA
State : GA
Zip : 30341-4115
Country : US
Telephone Number : 678-547-6012
Fax Number : 678-547-6008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 03/25/2014

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