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NPI Code Detail

MEDICARE: MRS. SUSAN ALICIA KNIGHT LCSW

MEDICARE: MRS. SUSAN ALICIA 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
11041S0200XSchool Social Worker137844NY
21041C0700XClinical Social Worker080217-1NY

General Provider Information

NPI Number : 1467761288
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN ALICIA KNIGHT LCSW
Provider Business Mailing Address
First Line : 379 MT HOPE RD
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-7135
Country : US
Telephone Number : 845-344-2292
Fax Number : 845-342-2054
Provider Business Practice Location Address
First Line : 379 MT HOPE RD
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-7135
Country : US
Telephone Number : 845-344-2292
Fax Number : 845-342-2054
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2010
Last Update Date : 12/11/2012

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