MEDICARE: MR. CHAD KNIGHT 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
1	1041C0700X	Clinical Social Worker	2427C	AL

General Provider Information

NPI Number	:	1407186703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD KNIGHT LCSW

Provider Business Mailing Address
First Line	:	604 8TH AVE NE
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-1728
Country	:	US
Telephone Number	:	256-343-3504
Fax Number	:

Provider Business Practice Location Address
First Line	:	1989 SARDIS DR
Second Line	:
City	:	BOAZ
State	:	AL
Zip	:	35956-2344
Country	:	US
Telephone Number	:	256-593-2371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2010
Last Update Date	:	02/17/2015

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Directions to “ MR. CHAD KNIGHT LCSW” Practice Location

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