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General NPI Number Information
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NPI Number | 1063871069
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Entity Type | Individual
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Provider Name | KENDRA M. KNIGHT LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 365 MONTAUK AVE
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City | NEW LONDON
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State | CT
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Zip | 06320-4700
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Country | US
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Telephone | 860-444-5141
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 415126
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City | BOSTON
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State | MA
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Zip | 02241-5126
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Country | US
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Telephone | 860-865-2231
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Fax | 475-246-9158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11778
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License Number State | CT
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