MEDICARE: MARCY COX LCDC

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

General Provider Information

NPI Number	:	1336824705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCY COX LCDC

Provider Business Mailing Address
First Line	:	4444 W MAIN ST
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-1737
Country	:	US
Telephone Number	:	281-460-0218
Fax Number	:	409-978-2401

Provider Business Practice Location Address
First Line	:	7510 FM 1765
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-3672
Country	:	US
Telephone Number	:	409-763-2373
Fax Number	:	409-978-2401

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

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	06/21/2023

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Directions to “ MARCY COX LCDC” Practice Location

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