Healthcare Provider Details

I. General information

NPI: 1912819038
Provider Name (Legal Business Name): MACKENZIE CLAIRE KNIGHTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15785 MEDICAL ARTS DR
HAMMOND LA
70403-1447
US

IV. Provider business mailing address

15785 MEDICAL ARTS DR
HAMMOND LA
70403-1447
US

V. Phone/Fax

Practice location:
  • Phone: 985-543-4082
  • Fax: 985-543-4090
Mailing address:
  • Phone: 985-543-4082
  • Fax: 985-543-4090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number18218
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: