Provider Demographics
NPI:1336950054
Name:KNOWLIN, ALEXIS RAQUEL (MS, LPC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RAQUEL
Last Name:KNOWLIN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 ST CHARLES CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2413
Mailing Address - Country:US
Mailing Address - Phone:757-812-9253
Mailing Address - Fax:
Practice Address - Street 1:9212 ST CHARLES CIR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-2413
Practice Address - Country:US
Practice Address - Phone:757-812-9253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health