Provider Demographics
NPI:1417609561
Name:KNOX FAMILY THERAPY, PLLC
Entity Type:Organization
Organization Name:KNOX FAMILY THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON-CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:865-973-9686
Mailing Address - Street 1:3624 VANDEVENTER AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4578
Mailing Address - Country:US
Mailing Address - Phone:865-973-9686
Mailing Address - Fax:855-617-4310
Practice Address - Street 1:3624 VANDEVENTER AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4578
Practice Address - Country:US
Practice Address - Phone:865-973-9686
Practice Address - Fax:855-617-4310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty