Individual
ERIC YOUNGBLOOD WILLIE MCKNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
150 CHESTNUT ST, FLOOR 5, PROVIDENCE, RI 02903-4645
(401) 465-0156
(401) 415-0325
Mailing address
150 CHESTNUT ST, FLOOR 5, PROVIDENCE, RI 02903-4645
(401) 465-0156
(401) 415-0325
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02135
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ISW02135
PROFESSIONAL LICENSE
RI
Enumeration date
03/02/2011
Last updated
01/02/2013
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