Provider Demographics
NPI:1326704412
Name:KNOTT, TARYNE (LCSW)
Entity type:Individual
Prefix:
First Name:TARYNE
Middle Name:
Last Name:KNOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-1422
Mailing Address - Country:US
Mailing Address - Phone:270-750-8666
Mailing Address - Fax:
Practice Address - Street 1:2072 OLD HIGHWAY 135 NW
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2006
Practice Address - Country:US
Practice Address - Phone:270-750-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2596851041C0700X
IN34011331A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical