Provider Demographics
NPI:1649424268
Name:KNOWLES, EMIL DWAIN (LMHC)
Entity Type:Individual
Prefix:MR
First Name:EMIL
Middle Name:DWAIN
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-0402
Mailing Address - Country:US
Mailing Address - Phone:904-284-8949
Mailing Address - Fax:
Practice Address - Street 1:2342 PARK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4318
Practice Address - Country:US
Practice Address - Phone:904-384-4910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8950101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health