Healthcare Provider Details

I. General information

NPI: 1740446400
Provider Name (Legal Business Name): HENRY L. KNOX JR. LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5257 OLD PINSON RD
BIRMINGHAM AL
35215-1065
US

IV. Provider business mailing address

5257 OLD PINSON RD
BIRMINGHAM AL
35215-1065
US

V. Phone/Fax

Practice location:
  • Phone: 205-936-7728
  • Fax:
Mailing address:
  • Phone: 205-936-7728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2335
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: