Provider Demographics
NPI:1144552456
Name:MCKNIGHT, ANN (LMSW)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S RIVER AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3144
Mailing Address - Country:US
Mailing Address - Phone:616-403-7303
Mailing Address - Fax:
Practice Address - Street 1:222 S RIVER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3144
Practice Address - Country:US
Practice Address - Phone:616-403-7303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010664241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical