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NPI Code Detail

MEDICARE: DAVID LEE COZADD LPC M.ED.

MEDICARE: DAVID LEE COZADD LPC M.ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor12718TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180471LOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1780754564
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID LEE COZADD LPC M.ED.
Provider Business Mailing Address
First Line : 4101 S MEDFORD DR
Second Line :
City : LUFKIN
State : TX
Zip : 75901-5633
Country : US
Telephone Number : 936-639-1141
Fax Number : 936-635-5695
Provider Business Practice Location Address
First Line : 4101 S MEDFORD DR
Second Line :
City : LUFKIN
State : TX
Zip : 75901-5633
Country : US
Telephone Number : 936-639-1141
Fax Number : 936-635-5695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/09/2007

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Directions to “ DAVID LEE COZADD LPC M.ED.” Practice Location

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