Provider Demographics
NPI:1386784668
Name:KNOX, PAUL I (RN LMHC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:I
Last Name:KNOX
Suffix:
Gender:M
Credentials:RN LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MCGRATH HWY
Mailing Address - Street 2:TWIN CITY OFFICES SUITE 204
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4508
Mailing Address - Country:US
Mailing Address - Phone:617-623-1814
Mailing Address - Fax:617-623-1817
Practice Address - Street 1:22 MCGRATH HWY
Practice Address - Street 2:TWIN CITY OFFICES SUITE 204
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-4508
Practice Address - Country:US
Practice Address - Phone:617-623-1814
Practice Address - Fax:617-623-1817
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3213101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health