Healthcare Provider Details

I. General information

NPI: 1538103734
Provider Name (Legal Business Name): CAROL J. MCKNIGHT M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 ROUTE 125
RIPTON VT
05766-0079
US

IV. Provider business mailing address

1306 ROUTE 125 PO BOX 79
RIPTON VT
05766-0079
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-6227
  • Fax: 802-388-4808
Mailing address:
  • Phone: 802-388-6227
  • Fax: 802-388-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068-0000088
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number047-0000520
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: