Provider Demographics
NPI:1023554664
Name:SHELLY COX LCSW
Entity Type:Organization
Organization Name:SHELLY COX LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-997-8552
Mailing Address - Street 1:6611 RIVER PLACE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-1162
Mailing Address - Country:US
Mailing Address - Phone:512-997-8552
Mailing Address - Fax:512-296-2510
Practice Address - Street 1:6611 RIVER PLACE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-1162
Practice Address - Country:US
Practice Address - Phone:512-997-8552
Practice Address - Fax:512-296-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX287231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty