Provider Demographics
NPI:1629440763
Name:KNIGHTSTEP, DANIEL DICKASON (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DICKASON
Last Name:KNIGHTSTEP
Suffix:
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHESTNUT ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1482
Mailing Address - Country:US
Mailing Address - Phone:325-788-5015
Mailing Address - Fax:800-925-0601
Practice Address - Street 1:500 CHESTNUT ST STE 203
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1482
Practice Address - Country:US
Practice Address - Phone:325-788-5015
Practice Address - Fax:800-925-0601
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71836101Y00000X, 101YP2500X
TX12273101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354103901Medicaid
TX13842812OtherCAQH