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NPI Code Detail

MEDICARE: MRS. OPAL KNIGHT MA, MHA, LPC, BC-TMH

MEDICARE: MRS. OPAL KNIGHT MA, MHA, LPC, BC-TMH
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
1101YP2500XProfessional Counselor012266GA
2101YP2500XProfessional Counselor9276NC
3101YP2500XProfessional Counselor5688SC

General Provider Information

NPI Number : 1447597604
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OPAL KNIGHT MA, MHA, LPC, BC-TMH
Provider Business Mailing Address
First Line : 136 FORUM DR STE 4
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-7980
Country : US
Telephone Number : 803-590-8924
Fax Number :
Provider Business Practice Location Address
First Line : 136 FORUM DR STE 4
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-7980
Country : US
Telephone Number : 803-590-8924
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2013
Last Update Date : 05/11/2022

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