Healthcare Provider Details

I. General information

NPI: 1891091054
Provider Name (Legal Business Name): CAROL E. KNIGHT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 HARMONY HILL RD
CHEPACHET RI
02814-1429
US

IV. Provider business mailing address

63 HARMONY HILL ROAD
CHEPACHET RI
02814-1429
US

V. Phone/Fax

Practice location:
  • Phone: 401-949-0690
  • Fax: 401-949-4412
Mailing address:
  • Phone: 401-949-0690
  • Fax: 401-949-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW01333
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: