Provider Demographics
NPI:1730125733
Name:KIGHT, NACOLE ALETRICE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NACOLE
Middle Name:ALETRICE
Last Name:KIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:NACOLE
Other - Middle Name:ALETRICE
Other - Last Name:YOUNG-OKOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:UNIT 5263 BOX 10
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96368-5263
Mailing Address - Country:US
Mailing Address - Phone:315-634-7968
Mailing Address - Fax:
Practice Address - Street 1:18TH MEDICAL GROUP
Practice Address - Street 2:UNIT 5142
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5142
Practice Address - Country:US
Practice Address - Phone:315-630-4780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0026401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical