MEDICARE: TESS KNIGHT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1275399727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESS KNIGHT LPC

Provider Business Mailing Address
First Line	:	6653 WEAVER RD STE 112
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61114-8068
Country	:	US
Telephone Number	:	815-201-2687
Fax Number	:

Provider Business Practice Location Address
First Line	:	6653 WEAVER RD STE 112
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61114-8068
Country	:	US
Telephone Number	:	815-201-2687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	02/22/2024

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Directions to “ TESS KNIGHT LPC” Practice Location

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