Provider Demographics
NPI:1083305619
Name:KNOTT, JOSEPH WILLIAM (MA)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:KNOTT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 GARLAND ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-2904
Mailing Address - Country:US
Mailing Address - Phone:402-476-3200
Mailing Address - Fax:
Practice Address - Street 1:5025 GARLAND ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-2904
Practice Address - Country:US
Practice Address - Phone:402-476-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13375101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health