Healthcare Provider Details

I. General information

NPI: 1720921653
Provider Name (Legal Business Name): ALLISON KNOTTS BICKETT PHD, MS, HSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 VAIL AVE STE 400B
CHARLOTTE NC
28207-1248
US

IV. Provider business mailing address

15503 WALNUT HILL DR
CHARLOTTE NC
28278-8914
US

V. Phone/Fax

Practice location:
  • Phone: 704-957-3959
  • Fax:
Mailing address:
  • Phone: 704-957-3959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number5862
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: