=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114135712
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELLEN COX LPCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2007
-----------------------------------------------------
Last Update Date | 01/12/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 218 COLUMBIA AVE
-----------------------------------------------------
City | GLASGOW
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42141-2932
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-651-7070
-----------------------------------------------------
Fax | 270-651-7071
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 SOUTHERN SCHOOL RD
-----------------------------------------------------
City | SOMERSET
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42501-3223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-679-4782
-----------------------------------------------------
Fax | 606-678-5296
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 162481
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------