Provider Demographics
NPI:1184383234
Name:KNIGHT, JACKELYN (LMSW)
Entity type:Individual
Prefix:
First Name:JACKELYN
Middle Name:
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 1:10609 LILAC PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1016
Mailing Address - Country:US
Mailing Address - Phone:615-419-0889
Mailing Address - Fax:
Practice Address - Street 1:10609 LILAC PL
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1016
Practice Address - Country:US
Practice Address - Phone:615-419-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD281141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical