| Doctor Name: | MR. JAY WILLIAM KNOTTS |
| NPI Number: | 1114918372 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MED LPC |
| License Number: | 4115 |
| Business Practice Address: | 625 Georgia Ave Center For Care And Counseling For The Csra Inc North Augusta, SC - 298413703 |
| Business Phone Number: | 8038198021 |
| Business Fax Number: | 8038199028 |
| Mailing Address: | 625 Georgia Ave, Center For Care And Counseling For The Csra Inc NORTH AUGUSTA |
| State: | SC |
| Postal Code: | 298413703 |
| Phone Number: | 8038198021 |
| Fax Number: | 8038199028 |
| NPI Enumeration Date: | 11/04/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4115 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |