Provider Demographics
NPI:1518664218
Name:KNIGHT, JESSICA E (LICSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:E
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 JEFFERSON BLVD UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3845
Mailing Address - Country:US
Mailing Address - Phone:401-753-8078
Mailing Address - Fax:
Practice Address - Street 1:765 WESTMINSTER ST STE 204
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4082
Practice Address - Country:US
Practice Address - Phone:401-744-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW037261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical