MEDICARE: MR. DONALD L. KNOLL M.S.W.

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	5010	TX
2	1041C0700X	Clinical Social Worker	01452	TX

General Provider Information

NPI Number	:	1649263237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD L. KNOLL M.S.W.

Provider Business Mailing Address
First Line	:	406 WOOD SHADOW ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-1636
Country	:	US
Telephone Number	:	210-496-0579
Fax Number	:	210-496-0579

Provider Business Practice Location Address
First Line	:	406 WOOD SHADOW ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-1636
Country	:	US
Telephone Number	:	210-496-0579
Fax Number	:	210-496-0579

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	09/11/2025

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