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General NPI Number Information
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NPI Number | 1023554664
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Entity Type | Organization
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Legal Business Name | SHELLY COX LCSW
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 6611 RIVER PLACE BLVD SUITE 203
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City | AUSTIN
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State | TX
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Zip | 78730-1162
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Country | US
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Telephone | 512-997-8552
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Fax | 512-296-2510
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Provider Business Mailing Address
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Address Line | 6611 RIVER PLACE BLVD SUITE 203
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City | AUSTIN
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State | TX
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Zip | 78730-1162
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Country | US
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Telephone | 512-997-8552
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Fax | 512-296-2510
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Authorized Official
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Title or Position | PRESIDENT/LCSW
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Name | SHELLY COX
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Credential | LCSW
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Telephone | 512-997-8552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 28723
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License Number State | TX
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