MEDICARE: AMY G COX LCSW

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	1041C0700X	Clinical Social Worker	256395	KY

General Provider Information

NPI Number	:	1871341925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY G COX LCSW

Provider Business Mailing Address
First Line	:	299 BARNER LN
Second Line	:
City	:	BARBOURVILLE
State	:	KY
Zip	:	40906-1873
Country	:	US
Telephone Number	:	606-521-5882
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 BOGLE ST STE 102
Second Line	:
City	:	SOMERSET
State	:	KY
Zip	:	42503-2849
Country	:	US
Telephone Number	:	606-676-0638
Fax Number	:

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

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	05/13/2024

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