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General NPI Number Information
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NPI Number | 1902078934
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Entity Type | Individual
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Provider Name | SHANDRE' K. COX K COX LPC, LCSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 103 S 19TH AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-6171
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Country | US
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Telephone | 601-544-4641
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Fax | 601-584-4053
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Provider Business Mailing Address
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Address Line | PO BOX 346
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City | LAKE
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State | MS
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Zip | 39092-0346
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Country | US
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Telephone | 601-880-3879
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1348
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 95922
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License Number State | CA
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