Healthcare Provider Details

I. General information

NPI: 1225940059
Provider Name (Legal Business Name): TEDDY COX COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 OLD MINDEN RD STE C
BOSSIER CITY LA
71112-2374
US

IV. Provider business mailing address

10162 TRAILRIDGE DR
SHREVEPORT LA
71106-7694
US

V. Phone/Fax

Practice location:
  • Phone: 318-674-4222
  • Fax:
Mailing address:
  • Phone: 318-393-8706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. THEODORE COX
Title or Position: MANAGING MEMBER
Credential: MA, LPC
Phone: 318-393-8706