Provider Demographics
NPI:1548546781
Name:KNOLES, MICHELLE E (LSCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:KNOLES
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22214 D ST
Mailing Address - Street 2:STROTHER FIELD
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-7376
Mailing Address - Country:US
Mailing Address - Phone:620-221-9664
Mailing Address - Fax:620-221-1983
Practice Address - Street 1:22214 D ST
Practice Address - Street 2:STROTHER FIELD
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-7376
Practice Address - Country:US
Practice Address - Phone:620-221-9664
Practice Address - Fax:620-221-1983
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW 3975104100000X
KS46071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker