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General NPI Number Information
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NPI Number | 1710493564
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Entity Type | Individual
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Provider Name | HATTIE TREADWELL COX NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3936 W ROOSEVELT RD STE 201
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City | CHICAGO
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State | IL
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Zip | 60624-4389
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Country | US
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Telephone | 773-826-0398
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Fax | 773-826-2327
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Provider Business Mailing Address
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Address Line | 6112 W DIVERSEY AVE UNIT D-1
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City | CHICAGO
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State | IL
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Zip | 60639-1186
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Country | US
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Telephone | 773-349-7956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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