Provider Demographics
NPI:1205263092
Name:KNOX, LIZZIE DUNBAR (EDD, LCSW)
Entity type:Individual
Prefix:DR
First Name:LIZZIE
Middle Name:DUNBAR
Last Name:KNOX
Suffix:
Gender:F
Credentials:EDD, LCSW
Other - Prefix:MS
Other - First Name:LIZZ
Other - Middle Name:DUNBAR
Other - Last Name:KNOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, MSW, EDD, LCSW
Mailing Address - Street 1:8917 THERMAL ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-4021
Mailing Address - Country:US
Mailing Address - Phone:510-635-3772
Mailing Address - Fax:
Practice Address - Street 1:8917 THERMAL ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-4021
Practice Address - Country:US
Practice Address - Phone:510-635-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 259961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical