MEDICARE: BERNARD DOUGLAS COX JR. LCMHC

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	101YM0800X	Mental Health Counselor	6564	NC

General Provider Information

NPI Number	:	1780881714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNARD DOUGLAS COX JR. LCMHC

Provider Business Mailing Address
First Line	:	5000 FALLS OF NEUSE RD STE 300
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-5480
Country	:	US
Telephone Number	:	919-865-8710
Fax Number	:	919-256-0772

Provider Business Practice Location Address
First Line	:	5000 FALLS OF NEUSE RD STE 300
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-5480
Country	:	US
Telephone Number	:	919-865-8710
Fax Number	:	919-256-0772

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

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	04/25/2022

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