Provider Demographics
NPI:1447778972
Name:MCKNIGHT GROUP LLC
Entity Type:Organization
Organization Name:MCKNIGHT GROUP LLC
Other - Org Name:LIVING PONO COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC, NCC
Authorized Official - Phone:847-989-4708
Mailing Address - Street 1:21299 W LAKEVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-9604
Mailing Address - Country:US
Mailing Address - Phone:847-989-4708
Mailing Address - Fax:
Practice Address - Street 1:1860 W WINCHESTER RD STE 205
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5317
Practice Address - Country:US
Practice Address - Phone:847-989-4708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCKNIGHT GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-05
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010886251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health