Provider Demographics
NPI:1104243617
Name:KNOTTS, CHRISTOPHER CLAY (MA, LCMHC, LCAS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CLAY
Last Name:KNOTTS
Suffix:
Gender:M
Credentials:MA, LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1894
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:227 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-3058
Practice Address - Country:US
Practice Address - Phone:910-572-3681
Practice Address - Fax:910-572-5579
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21612101YA0400X
NC10342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1104243617OtherHUMANA
NC19GSUOtherBCBS
NC6001137-581OtherMAGELLAN
NC1104243617Medicaid