Provider Demographics
NPI:1861919292
Name:KNIPP, MEGAN (ASW, NC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KNIPP
Suffix:
Gender:F
Credentials:ASW, NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 BRADFORD WAY APT B
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2905
Mailing Address - Country:US
Mailing Address - Phone:410-299-9098
Mailing Address - Fax:
Practice Address - Street 1:715 BRADFORD WAY APT B
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-2905
Practice Address - Country:US
Practice Address - Phone:410-299-9098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker