Provider Demographics
NPI:1750970844
Name:KNOX, DIANE (LMFT)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:KNOX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 SULLIVAN AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-6002
Mailing Address - Country:US
Mailing Address - Phone:860-791-2062
Mailing Address - Fax:860-955-1524
Practice Address - Street 1:915 SULLIVAN AVE STE 8
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-6002
Practice Address - Country:US
Practice Address - Phone:860-646-3888
Practice Address - Fax:860-731-5536
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CT003109106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist