Healthcare Provider Details

I. General information

NPI: 1275287765
Provider Name (Legal Business Name): SYLVIA M KNOTTS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SYLVIA M KNOTTS LMSW

II. Dates (important events)

Enumeration Date: 02/04/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 SAKELARES BLVD
GRANTS NM
87020-3819
US

IV. Provider business mailing address

PO BOX 2064
MILAN NM
87021-2064
US

V. Phone/Fax

Practice location:
  • Phone: 505-876-1890
  • Fax: 505-443-8343
Mailing address:
  • Phone: 505-658-9164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2023-0433
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: