Individual provider Active NPI

Lela Renee McKnight-Eily, PHD

  • Clinical Psychologist
  • Marietta, GA
National Provider Identifier
1407056369
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY002804 Issued in GA
Practice address
698 N Marietta Pkwy NE
Marietta, GA 30060-1529
Phone
(770) 919-9088
Fax
(770) 919-8708
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY002804 GA Primary

Addresses

Primary practice location

698 N Marietta Pkwy NE
Marietta, GA 30060-1529

Mailing address

4770 Buford Hwy
Mailstop 67
Atlanta, GA 30341-3717
Phone (770) 488-8124

Other names 1

  • Dr. Lela Renee McKnight Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY002804GAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1407056369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 BUFORD HWY",
            "address_2": "MAILSTOP 67",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303413717",
            "telephone_number": "770-488-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 N MARIETTA PKWY NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601529",
            "telephone_number": "770-919-9088",
            "fax_number": "770-919-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT-EILY",
        "first_name": "LELA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LELA",
            "last_name": "MCKNIGHT",
            "middle_name": "RENEE",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.