Provider Demographics
NPI:1972958742
Name:MCKNIGHT, SARAH (MS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:EGGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:810 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KEWAUNEE
Mailing Address - State:WI
Mailing Address - Zip Code:54216-1140
Mailing Address - Country:US
Mailing Address - Phone:920-388-7030
Mailing Address - Fax:920-388-7124
Practice Address - Street 1:810 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:KEWAUNEE
Practice Address - State:WI
Practice Address - Zip Code:54216-1140
Practice Address - Country:US
Practice Address - Phone:920-388-7030
Practice Address - Fax:920-388-7124
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17593-130101YA0400X
WI2871-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)