Provider Demographics
NPI:1477048981
Name:KNOX, BRIANNA JANAI (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:JANAI
Last Name:KNOX
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 1:9311 JW CLAY BLVD
Mailing Address - Street 2:STE A, #2009
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:980-288-4592
Mailing Address - Fax:
Practice Address - Street 1:9311 JW CLAY BLVD
Practice Address - Street 2:STE A, #2009
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:980-288-4592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040145691041C0700X
NCC0133571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14281468OtherCAQH