Provider Demographics
NPI:1982715900
Name:KNOX, HEATHER L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:L
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 1:11300 PASEO DEL OSO NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2665
Mailing Address - Country:US
Mailing Address - Phone:505-362-0942
Mailing Address - Fax:505-232-3728
Practice Address - Street 1:11300 PASEO DEL OSO NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2665
Practice Address - Country:US
Practice Address - Phone:505-362-0942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-38011041C0700X, 1041S0200X
NMC-38011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool