MEDICARE: KIMBERLEY KNOX MA, LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC015051	GA

General Provider Information

NPI Number	:	1275266504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLEY KNOX MA, LPC, NCC

Provider Business Mailing Address
First Line	:	75 RIVA RIDGE LN
Second Line	:
City	:	NEWNAN
State	:	GA
Zip	:	30263-6709
Country	:	US
Telephone Number	:	678-876-0005
Fax Number	:

Provider Business Practice Location Address
First Line	:	4751 BEST RD STE 470
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30337-5615
Country	:	US
Telephone Number	:	470-344-3942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2022
Last Update Date	:	01/27/2025

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