Individual provider Active NPI

Debra J Knox, LMFT

  • Marriage & Family Therapist
  • Avon, CT
National Provider Identifier
1205126406
Registry record updated Apr 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001442 Issued in CT
Practice address
412 W Avon Rd
Avon, CT 06001-2500
Phone
(860) 269-0510
NPI assigned
Apr 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001442 CT Primary

Addresses

Primary practice location

412 W Avon Rd
Avon, CT 06001-2500

Mailing address

5 Wagon Hill LN
Avon, CT 06001-2419
Phone (860) 751-9213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103004448 VA Practitioner - Marriage and Family Therapist 9436500451 Practice locations: Clarksville, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001442CTMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302393600000",
    "number": "1205126406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WAGON HILL LN",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012419",
            "telephone_number": "860-751-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W AVON RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012500",
            "telephone_number": "860-269-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "DEBRA",
        "middle_name": "J",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-10",
        "last_updated": "2011-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.