Healthcare Provider Details

I. General information

NPI: 1982245643
Provider Name (Legal Business Name): JAMES WOODCOX LICSW, ADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 COLUMBIA HWY
DOTHAN AL
36303-5434
US

IV. Provider business mailing address

509 OWENS ST
DOTHAN AL
36301-5041
US

V. Phone/Fax

Practice location:
  • Phone: 334-790-8286
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4361C
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: