Provider Demographics
NPI:1720183619
Name:KNIGHT, CAROL JEANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEANNE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:BUSHLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79012-0211
Mailing Address - Country:US
Mailing Address - Phone:806-683-1524
Mailing Address - Fax:
Practice Address - Street 1:6666 W AMARILLO BLVD
Practice Address - Street 2:SUITE 28
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1756
Practice Address - Country:US
Practice Address - Phone:806-683-1524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18819101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1663767Medicaid