Provider Demographics
NPI:1285116038
Name:KNOX, CARRIE TROGDON (LPC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:TROGDON
Last Name:KNOX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8712 SUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4405
Mailing Address - Country:US
Mailing Address - Phone:910-228-4798
Mailing Address - Fax:
Practice Address - Street 1:8712 SUDLEY RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4405
Practice Address - Country:US
Practice Address - Phone:571-599-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1226101YA0400X
VA0701007838101YP2500X
VA0718000243101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)