Provider Demographics
NPI:1982279865
Name:KNIGHTEN, ASEELAH (LMHC)
Entity Type:Individual
Prefix:
First Name:ASEELAH
Middle Name:
Last Name:KNIGHTEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 865300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-5300
Mailing Address - Country:US
Mailing Address - Phone:954-314-8338
Mailing Address - Fax:
Practice Address - Street 1:1062 LAKE SEBRING DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1426
Practice Address - Country:US
Practice Address - Phone:954-314-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health