Jennifer Bahamon McKnight, MED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

91222 Issued in TX

Practice address

3131 Executive Dr
San Angelo, TX 76904-6801

Phone

(325) 307-3040

NPI assigned

Aug 24, 2023

Last updated

Aug 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1942084330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046801",
            "telephone_number": "325-307-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046801",
            "telephone_number": "325-307-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "JENNIFER",
        "middle_name": "BAHAMON",
        "name_prefix": "Mrs.",
        "credential": "MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "91222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley McIver, MD
• Anna Catherine McKenzie
• Clinton McKenzie
• Emily Christine McKenzie, LCDC
• Charles McKnight, LCDC
• Doreen Elizabeth McLaughlin
• Galina R McLaughlin, D.O
• Jacklyn Elaine McMeekin
• Lindsey Rechelle McMillan, PT
• Lillie Rebecca McMinn, AUD

• Mental Health Counselor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.