Provider Demographics
NPI:1861967820
Name:KNOWLES, VERONICA (LCSW)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 HIGHWAY 393
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39339-9533
Mailing Address - Country:US
Mailing Address - Phone:662-617-4180
Mailing Address - Fax:
Practice Address - Street 1:8613 MS HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:ACKERMAN
Practice Address - State:MS
Practice Address - Zip Code:39735-8917
Practice Address - Country:US
Practice Address - Phone:601-781-8677
Practice Address - Fax:601-676-0550
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical