Provider Demographics
NPI:1164791240
Name:COX, TABATHA ATKINS (MA,QS-LCMHC,LCAS,CCS)
Entity Type:Individual
Prefix:
First Name:TABATHA
Middle Name:ATKINS
Last Name:COX
Suffix:
Gender:F
Credentials:MA,QS-LCMHC,LCAS,CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-3116
Mailing Address - Country:US
Mailing Address - Phone:336-401-3464
Mailing Address - Fax:
Practice Address - Street 1:8025 N POINT BLVD STE 139
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3262
Practice Address - Country:US
Practice Address - Phone:336-546-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2556101YA0400X
NC2556A101YA0400X
NC9401101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional