Provider Demographics
NPI:1780041822
Name:FOX, NEVA DANIELLE KNIGHT (LMFT)
Entity Type:Individual
Prefix:MS
First Name:NEVA
Middle Name:DANIELLE KNIGHT
Last Name:FOX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:NEVA
Other - Middle Name:D KNIGHT
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:404 CORDER RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7195
Mailing Address - Country:US
Mailing Address - Phone:478-283-8322
Mailing Address - Fax:
Practice Address - Street 1:404 CORDER RD STE 300
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7195
Practice Address - Country:US
Practice Address - Phone:478-449-1475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
GA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003209756AMedicaid
GAMFT001629OtherLICENSE LMFT