Provider Demographics
NPI:1639354616
Name:COUCOULAS KNIGHT, ANDREA JOETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JOETTE
Last Name:COUCOULAS KNIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 OXBOW CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4837
Mailing Address - Country:US
Mailing Address - Phone:919-968-6016
Mailing Address - Fax:
Practice Address - Street 1:834 OXBOW CROSSING RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-4837
Practice Address - Country:US
Practice Address - Phone:919-968-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4318101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4318OtherLPC LICENSE NUMBER 4318
NC57777OtherNCC