MEDICARE: JACQUELINE ROSE COX LGSW

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	104100000X	Social Worker	LG200004671	DC

General Provider Information

NPI Number	:	1316604481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE ROSE COX LGSW

Provider Business Mailing Address
First Line	:	2601 16TH ST NW APT 318
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6259
Country	:	US
Telephone Number	:	248-990-7478
Fax Number	:

Provider Business Practice Location Address
First Line	:	712 H ST NE # 8886
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3627
Country	:	US
Telephone Number	:	202-854-0067
Fax Number	:	202-810-9000

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

Provider Enumeration Date	:	11/23/2021
Last Update Date	:	02/04/2026

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