Healthcare Provider Details

I. General information

NPI: 1336428515
Provider Name (Legal Business Name): MONIQUE HALL KNIGHT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONIQUE DIONNE HALL

II. Dates (important events)

Enumeration Date: 08/05/2011
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 MALL RING RD STE 210
STONECREST GA
30038-2698
US

IV. Provider business mailing address

1429 SMITHSON DR
LITHONIA GA
30058-6155
US

V. Phone/Fax

Practice location:
  • Phone: 404-585-7533
  • Fax:
Mailing address:
  • Phone: 404-399-1366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC005853
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: