Provider Demographics
NPI:1710607270
Name:KNIGHT, CAMILLE LYNN (LLPC)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:LYNN
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:LYNN
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSC
Mailing Address - Street 1:32338 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-8996
Mailing Address - Country:US
Mailing Address - Phone:574-370-1052
Mailing Address - Fax:
Practice Address - Street 1:2650 HORIZON DRIVE
Practice Address - Street 2:CASCADE OFFICE PARK 4, SE #225
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:906-322-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MI6451021969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health