Provider Demographics
NPI:1528547403
Name:RICK KNIGHTS, LICSW, LLC
Entity Type:Organization
Organization Name:RICK KNIGHTS, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RODERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:KNIGHTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-356-5001
Mailing Address - Street 1:2800 HALE ROAD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05819-9616
Mailing Address - Country:US
Mailing Address - Phone:802-356-5001
Mailing Address - Fax:
Practice Address - Street 1:40 LAKEMONT RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9459
Practice Address - Country:US
Practice Address - Phone:802-334-1430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01307761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty