| Knu Scope | |
|
4043 Big Valley Trl # A Stone Mountain GA 30083-5711 | |
| (770) 899-2849 | |
| Not Available |
| Full Name | Knu Scope |
|---|---|
| Speciality | Counselor |
| Location | 4043 Big Valley Trl # A, Stone Mountain, Georgia |
| Authorized Official Name and Position | Kenyon T. Lindsey (CEO) |
| Authorized Official Contact | 7708992849 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Knu Scope 4043 Big Valley Trl # A Stone Mountain GA 30083-5711 Ph: (770) 899-2849 | Knu Scope 4043 Big Valley Trl # A Stone Mountain GA 30083-5711 Ph: (770) 899-2849 |
| NPI Number | 1073468286 |
|---|---|
| Provider Enumeration Date | 03/03/2026 |
| Last Update Date | 05/11/2026 |
| Certification Date | 05/11/2026 |
| Medicare PECOS PAC ID | 1850860057 |
|---|---|
| Medicare Enrollment ID | O20260518000975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073468286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 171M00000X | Case Manager/care Coordinator | () | Secondary |
| Provider Name | Kenyon Lindsey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760068944 PECOS PAC ID: 2769951961 Enrollment ID: I20260518001340 |
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