MEDICARE: AMY KNAPP

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
1	101YP2500X	Professional Counselor	6401020341	MI

General Provider Information

NPI Number	:	1558845180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY KNAPP

Provider Business Mailing Address
First Line	:	PO BOX 5313
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-0313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 WASHINGTON AVE STE 220
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-1462
Country	:	US
Telephone Number	:	616-842-6710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2018
Last Update Date	:	12/27/2024

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