Provider Demographics
NPI:1841413119
Name:KNIGHT, ALYSON RENAE (LSW, LCPC)
Entity Type:Individual
Prefix:MS
First Name:ALYSON
Middle Name:RENAE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LSW, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 HOLGATE DRIVE
Mailing Address - Street 2:UNIT G4
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021
Mailing Address - Country:US
Mailing Address - Phone:618-520-9366
Mailing Address - Fax:
Practice Address - Street 1:8601 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-1719
Practice Address - Country:US
Practice Address - Phone:618-394-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker