Provider Demographics
NPI:1255202297
Name:KNOP, DEIDRE (LCSW)
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:
Last Name:KNOP
Suffix:
Gender:X
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 PAMONA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3361
Mailing Address - Country:US
Mailing Address - Phone:317-456-2487
Mailing Address - Fax:
Practice Address - Street 1:7230 ARBUCKLE CMNS
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1791
Practice Address - Country:US
Practice Address - Phone:317-456-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002265A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical