Basic Information
| Provider Information | |||||||||
| NPI: | 1497939797 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COX | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | WAYNE | ||||||||
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| Credential: | LCSW,LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1513 PICKENS ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292013448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037659944 | ||||||||
| FaxNumber: | 8037996267 | ||||||||
| Practice Location | |||||||||
| Address1: | 1513 PICKENS ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292013448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037659944 | ||||||||
| FaxNumber: | 8037996267 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2007 | ||||||||
| LastUpdateDate: | 12/21/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 34000042A | IN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 106H00000X | 35000036A | IN | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.