Provider Demographics
NPI:1598321416
Name:KNIGHT KING, ARIEL CHANTEL (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:CHANTEL
Last Name:KNIGHT KING
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:CHANTEL
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:546 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9726
Mailing Address - Country:US
Mailing Address - Phone:585-773-0058
Mailing Address - Fax:
Practice Address - Street 1:546 SHORE DR
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9726
Practice Address - Country:US
Practice Address - Phone:585-773-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0804521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY080452OtherSOCIAL WORK LICENSURE NUMBER
NY14082148OtherCAQH