Healthcare Provider Details

I. General information

NPI: 1518467240
Provider Name (Legal Business Name): RHETT KNUTH LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 TAYLORS MILLS RD
MANALAPAN NJ
07726-3255
US

IV. Provider business mailing address

1-6 ATLANTA CT
FREEHOLD NJ
07728-3602
US

V. Phone/Fax

Practice location:
  • Phone: 908-415-2042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05755600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: