Provider Demographics
NPI:1144634783
Name:KNAFF, AUDREY VIRGINIA (LISW-S)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:VIRGINIA
Last Name:KNAFF
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W WILSON BRIDGE RD STE 245
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2283
Mailing Address - Country:US
Mailing Address - Phone:614-224-6617
Mailing Address - Fax:855-208-4527
Practice Address - Street 1:245 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2641
Practice Address - Country:US
Practice Address - Phone:614-999-1134
Practice Address - Fax:614-586-4252
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI13034081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical