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NPI Code Detail

MEDICARE: MR. BRIAN MCKNIGHT LCSW

MEDICARE: MR. BRIAN MCKNIGHT LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6983WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275537813
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN MCKNIGHT LCSW
Provider Business Mailing Address
First Line : 1821 S STOUGHTON RD
Second Line :
City : MADISON
State : WI
Zip : 53716-2257
Country : US
Telephone Number : 608-260-6000
Fax Number : 608-260-6376
Provider Business Practice Location Address
First Line : 1821 S STOUGHTON RD
Second Line :
City : MADISON
State : WI
Zip : 53716-2257
Country : US
Telephone Number : 608-260-6000
Fax Number : 608-260-6376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 08/26/2021

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