MEDICARE: VIRGINIA COX CDCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	167008	OH

General Provider Information

NPI Number	:	1053801506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA COX CDCA

Provider Business Mailing Address
First Line	:	999 HARRISON AVE
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-3510
Country	:	US
Telephone Number	:	513-218-7726
Fax Number	:

Provider Business Practice Location Address
First Line	:	516 HIGH ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45011-6003
Country	:	US
Telephone Number	:	513-896-2103
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2018
Last Update Date	:	05/10/2018

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Directions to “ VIRGINIA COX CDCA” Practice Location

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