Provider Demographics
NPI:1871967273
Name:KNEESSY, DAVE (MS, MAC, MCAP, LMHC)
Entity type:Individual
Prefix:MR
First Name:DAVE
Middle Name:
Last Name:KNEESSY
Suffix:
Gender:M
Credentials:MS, MAC, MCAP, LMHC
Other - Prefix:MR
Other - First Name:G.
Other - Middle Name:DAVY
Other - Last Name:KNEESSY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MAC, MCAP, LMHC
Mailing Address - Street 1:2198 HARRIS AVE NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4002
Mailing Address - Country:US
Mailing Address - Phone:321-951-9750
Mailing Address - Fax:321-951-9765
Practice Address - Street 1:2198 HARRIS AVE NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4002
Practice Address - Country:US
Practice Address - Phone:321-951-9750
Practice Address - Fax:321-951-9765
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-23
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000279A251S00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No251S00000XAgenciesCommunity/Behavioral Health