Provider Demographics
NPI:1780968933
Name:KNOX, ABBEY HAYDIS (MA, LMHC, NCC)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:HAYDIS
Last Name:KNOX
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 SW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-5935
Mailing Address - Country:US
Mailing Address - Phone:954-593-3662
Mailing Address - Fax:561-732-8612
Practice Address - Street 1:127 SW 12TH AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-5935
Practice Address - Country:US
Practice Address - Phone:813-928-0952
Practice Address - Fax:561-732-8612
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4343101Y00000X
FLMH4343101YM0800X, 101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43810OtherNCC-NATIONAL CERTIFIED COUNSELOR
FLMH 4343OtherSTATE OF FLORIDA DEPT. OF HEALTH