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General NPI Number Information
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NPI Number | 1205940509
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Entity Type | Individual
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Provider Name | BEVERLY KNIGHTEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 1 FREEDOM WAY
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City | AUGUSTA
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State | GA
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Zip | 30904-6258
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Country | US
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Telephone | 706-733-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 ELK DR
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City | MCALESTER
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State | OK
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Zip | 74501-7606
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Country | US
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Telephone | 229-584-2540
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Fax | 229-226-2036
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4950
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW005914
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7117
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2283-C
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License Number State | AR
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