Provider Demographics
NPI:1255189684
Name:KNOX, CARMEN BROOKE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:BROOKE
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 1:105 S NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2964
Mailing Address - Country:US
Mailing Address - Phone:256-872-0110
Mailing Address - Fax:
Practice Address - Street 1:105 S NORTON AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2964
Practice Address - Country:US
Practice Address - Phone:256-872-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1277181041C0700X
VA09040160981041C0700X
AL5333C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical