Provider Demographics
NPI:1437326634
Name:KNOPP, LAURA DIANE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DIANE
Last Name:KNOPP
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 694
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56538-0694
Mailing Address - Country:US
Mailing Address - Phone:952-681-2983
Mailing Address - Fax:952-679-7484
Practice Address - Street 1:210 N CASCADE ST STE 3
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2254
Practice Address - Country:US
Practice Address - Phone:952-681-2983
Practice Address - Fax:952-679-7484
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1212621041C0700X
MN133841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty