=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346573128
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THADDEUS MARTIN COX LPC-S, LPA, PHD, LP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2009
-----------------------------------------------------
Last Update Date | 08/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2604 HILLSIDE DR
-----------------------------------------------------
City | HIGHLAND VILLAGE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75077-8698
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-812-0263
-----------------------------------------------------
Fax | 972-966-2375
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4202 TULE CV
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78749-3822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-812-0263
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | LPC.0021362
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 62696
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 35694
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 068.0135481TELE
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 62696
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------