MEDICARE: JORDYN KNOTT

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	101YM0800X	Mental Health Counselor	MH26541	FL

General Provider Information

NPI Number	:	1568248615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDYN KNOTT

Provider Business Mailing Address
First Line	:	3211 SE BROOK ST
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-6774
Country	:	US
Telephone Number	:	772-323-6882
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 NW CENTRAL PARK PLZ STE 105
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-1825
Country	:	US
Telephone Number	:	772-303-1987
Fax Number	:

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

Provider Enumeration Date	:	09/05/2023
Last Update Date	:	12/09/2025

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