Provider Demographics
NPI:1144352733
Name:COX, HEATHER MC MATH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MC MATH
Last Name:COX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 IRA YOUNG DR APT 1324
Mailing Address - Street 2:CHAPPELL HILL APTS
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6370
Mailing Address - Country:US
Mailing Address - Phone:817-966-8150
Mailing Address - Fax:
Practice Address - Street 1:3009 IRA YOUNG DR APT 1324
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6370
Practice Address - Country:US
Practice Address - Phone:817-966-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38537104100000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38537OtherLICENSE NUMBER OF SOCIAL WORK LICENSE