=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134511850
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KATHRYN M. COX, LPC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2015
-----------------------------------------------------
Last Update Date | 03/04/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1629 4TH AVE SE SUITE 114
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35601-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-686-2935
-----------------------------------------------------
Fax | 256-615-8667
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1629 4TH AVE SE SUITE 114
-----------------------------------------------------
City | DECATUR
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35601-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-686-2935
-----------------------------------------------------
Fax | 256-615-8667
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. KATHRYN M COX
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 256-686-3984
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 2588
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------