Healthcare Provider Details

I. General information

NPI: 1457603417
Provider Name (Legal Business Name): WILLIAM C COX III LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 02/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 HEMPSTEAD ST
NEW LONDON CT
06320-6204
US

IV. Provider business mailing address

187B STERLING CT
LAKEWOOD NJ
08701-6695
US

V. Phone/Fax

Practice location:
  • Phone: 860-443-2896
  • Fax: 860-442-5909
Mailing address:
  • Phone: 860-227-3485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1712
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: