Provider Demographics
NPI:1942062542
Name:KNIGHT, GABRIELLE RENEE (LMSW)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:RENEE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1436
Mailing Address - Country:US
Mailing Address - Phone:515-452-0284
Mailing Address - Fax:515-598-7452
Practice Address - Street 1:1730 28TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1436
Practice Address - Country:US
Practice Address - Phone:515-452-0284
Practice Address - Fax:515-598-7452
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA122780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health