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Individual

LARRY W KNOPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA LCPC

Contact information

Practice address
16342 N IL HWY 37, MT VERNON, IL 62864
(618) 242-1510
(618) 242-0958
Mailing address
PO BOX 428, MT VERNON, IL 62864
(618) 242-1510
(618) 242-0958

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004115177
BCBS
IL
01
295215
HEALTHLINK
Enumeration date
07/24/2006
Last updated
07/08/2007
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