Provider Demographics
NPI:1083868814
Name:KNIGHT, MARK STEPHEN (BCBA, NCC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:STEPHEN
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:BCBA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E. GEORGIA ST.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODRUFF
Mailing Address - State:SC
Mailing Address - Zip Code:29388
Mailing Address - Country:US
Mailing Address - Phone:864-476-7400
Mailing Address - Fax:864-476-0033
Practice Address - Street 1:751 E. GEORGIA ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388
Practice Address - Country:US
Practice Address - Phone:864-476-7400
Practice Address - Fax:864-476-0033
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1084412103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst