Provider Demographics
NPI:1518474097
Name:KNIGHT, CARA GRACE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:GRACE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 AVEMORE SQUARE PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7228
Mailing Address - Country:US
Mailing Address - Phone:402-661-0468
Mailing Address - Fax:
Practice Address - Street 1:1112 2ND ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4711
Practice Address - Country:US
Practice Address - Phone:540-215-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007359101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437137734Medicaid