Provider Demographics
NPI:1457707762
Name:KNIGHT-WILLIAMS, SAMANTHA LYNN
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LYNN
Last Name:KNIGHT-WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-3205
Mailing Address - Country:US
Mailing Address - Phone:908-531-3996
Mailing Address - Fax:
Practice Address - Street 1:ATTN 18205
Practice Address - Street 2:5505 N CUMBERLAND AVE STE 307
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-1471
Practice Address - Country:US
Practice Address - Phone:908-441-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00879500101YP2500X
NY010480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional