Healthcare Provider Details

I. General information

NPI: 1124420765
Provider Name (Legal Business Name): COREY GISSENDANNER COX LPC, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2014
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8455 E RADCLIFF AVE
DENVER CO
80237-2503
US

IV. Provider business mailing address

8455 E RADCLIFF AVE
DENVER CO
80237-2503
US

V. Phone/Fax

Practice location:
  • Phone: 720-495-4036
  • Fax:
Mailing address:
  • Phone: 720-495-4036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0002435
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0019315
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0019315
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: