Provider Demographics
NPI:1407186703
Name:KNIGHT, CHAD (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 8TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-1728
Mailing Address - Country:US
Mailing Address - Phone:256-343-3504
Mailing Address - Fax:
Practice Address - Street 1:1989 SARDIS DR
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35956-2344
Practice Address - Country:US
Practice Address - Phone:256-593-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2427C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical