1225656127 NPI number — COURTNEY COX MA, CMHP

Table of content: COURTNEY COX MA, CMHP (NPI 1225656127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225656127 NPI number — COURTNEY COX MA, CMHP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COX
Provider First Name:
COURTNEY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, CMHP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225656127
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 289
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MASON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48854-0289
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-676-5405
Provider Business Mailing Address Fax Number:
517-676-5460

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
G3169 BEECHER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532-3611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-237-0799
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)