Provider Demographics
NPI:1487219770
Name:KNIGHT, NYESIA (LCSW)
Entity Type:Individual
Prefix:
First Name:NYESIA
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3449 NORTON PL
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-6595
Mailing Address - Country:US
Mailing Address - Phone:803-834-1229
Mailing Address - Fax:
Practice Address - Street 1:304 JANET ST STE H
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2643
Practice Address - Country:US
Practice Address - Phone:229-560-5418
Practice Address - Fax:229-233-3101
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1014101YA0400X
GACSW0080851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)