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NPI Code Detail

MEDICARE: JORDAN COX LCDCII, CT

MEDICARE: JORDAN COX LCDCII, CT
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
1101Y00000XCounselorC.2607479-TRNEOH
2101YA0400XAddiction (Substance Use Disorder) CounselorLCDCII.162010OH

General Provider Information

NPI Number : 1609362953
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN COX LCDCII, CT
Provider Business Mailing Address
First Line : 4522 FULTON DR NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2332
Country : US
Telephone Number : 330-915-2907
Fax Number : 330-915-2958
Provider Business Practice Location Address
First Line : 4522 FULTON DR NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2332
Country : US
Telephone Number : 330-915-2907
Fax Number : 330-915-2907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2018
Last Update Date : 01/15/2026

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Directions to “ JORDAN COX LCDCII, CT” Practice Location

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