KEVIN BRUCE KNICKERBOCKER MA, LPC
NPI 1043929938
Counselor - Professional in Davison, MI
- Individual
- Male
- Counselor
- Professional
About KEVIN KNICKERBOCKER
This page provides the complete NPI Profile along with additional information for Kevin Knickerbocker, a provider established in Davison, Michigan with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1043929938 assigned on November 2022. The practitioner's primary taxonomy code is 101YP2500X with license number 6401000014 (MI). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1043929938 Verify this NPI
- Provider Name
- KEVIN BRUCE KNICKERBOCKER MA, LPC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 8454 N HENDERSON RD DAVISON, MI 48423
- Location Phone
- (810) 834-7769
- Mailing Address
- 8454 N HENDERSON RD DAVISON, MI 48423
- Mailing Phone
- (810) 834-7769
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-18-2022
- Last Update Date
- 11-18-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 6401000014
- License State
- MI
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043929938, enumerated as an "individual" on November 18, 2022.
The provider is located at 8454 N HENDERSON RD DAVISON, MI 48423 and the phone number is (810) 834-7769.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
